A Medicare Refresher Course
by Harry Lockhart

     The annual enrollment period for Medicare eligibility is from Nov. 15 to Dec. 31, and it’s not too early for a Medicare refresher course.  In fact, while I was in my gym’s sauna the other day, a man asked me about Medicare, knowing my background. I have worked in the Medicare insurance field 32 years.
     So, help is definitely available for navigating the system. It’s important, because if you make a mistake, you could lose out on coverage.
    The basics are these. Medicare has four plans. Part A covers hospital inpatient care and skilled nursing care. It charges co-payments based on the number of days spent getting the services. You or your spouse’s work history, measured in qualifying quarters, determines if you are eligible.
    Part B: covers visits to the doctor, outpatient care, x-rays and laboratory tests. In other words, this plan excludes inpatient services. Medicare covers 80 percent of the approved charges; the rest is up to you. “B” has an annual deductible of $135. Beneficiaries also pay $96.40 monthly to Medicare. Higher-income participants may pay more.
    Part C (called Medicare Advantage) is a less-known plan that covers services that Parts A and B don’t. This plan is offered through private insurance companies, but the funding is still from Medicare.  Many of these insured pay no premium for C. But they still pay the $96.40 monthly to belong to Medicare.
    Part D is a Prescription Drug Coverage. Medicare requires this plan, done through an insurance company, and penalizes people who don’t sign up when first eligible.
     There is one more aspect about the four parts. Being on Parts A and B means you are excluded from C. You can be on C and D at the same time, however. And, of course, you can be on A, B and D simultaneously.
     Then there are the additional points.  Some private insurance companies offer policies to help deal with the shortfalls of Medicare. Those policies are referred to as “Medicare supplements,” but are funded privately. There are about a dozen such types of policies.  It can be confusing, because those policies are named by letters of the alphabet, which is how Medicare names its plans.
    Regardless of the insurer, all the private companies offer the same coverage for a given type of need.  Cost of the coverage and strength of the insurance carrier vary.