In the USA, you're entitled to Social Security benefits as well as Medicare benefits. Medicare part A covers hospitalization and hospital expenses. Medicare Part B covers 80% of approved physician visits, some therapy
visits, and sometimes day-care and home-care.
Medicare Part B has a monthly premium that is deducted from the Social Security monthly check you'd otherwise receive. Therefore, you might opt out of Part B coverage and not choose to contribute to this benefit program. But what if...you (or that loved one) become ill? It can be financially devastating as physicians and other medical providers charge retail fees and none of these fees will be covered by your Part A benefits.
Recommendation: As a Medicare part A recipient, it's prudent to contribute to the Part B program as well. Once a part B recipient, the doctor charges are covered up to 80% of the Medicare approved fees. This means that the retail charges of $500 may be reduced to a Medicare approved charge of $100, and 80% will be paid by Medicare. The remaining 20% is payable by the Medicare part B recipient. The Medicare recipient can then decide to purchase a Medicare supplement plan to cover the extra 20% of the part B charges. The other option is to choose a Medicare HMO plan that covers 100% of provider fees for providers who belong to the HMO
(Health Maintenance Organization). An HMO plan limits who you, as a recipient, can receive medical-care from.
We are presently in the annual period where changing a Medicare Supplemental Part B Plan is possible. Yes, the number and complexity of available plans can be overwhelming to the Medicare recipient. First, the decision has to be made as to whether the preferred doctors of the recipient participate in a new plan. Once this is determined, each insurance company offers two types of plans: premium paid monthly or HMO plans.
The premiums paid-monthly plans can range from $29 per month up to $300 plus per month. More expensive plans may include eye care and exams, dental care, and even home-care services. The least expensive plans offer basic coverage only.
The HMO plans are all inclusive and do not have any additional monthly fees. The Medicare Part B premium, withheld from the recipient's Social Security check monthly, covers these plans.
The attractiveness of an HMO plan is that there is no out-of pocket expense of a monthly premium above the basic Medicare Part B already deducted from the Social Security check. For a private, personalized "consult," you can contact me at 718-442-2414 or 212-889-3806.
Warmly, Holly Gemme