Medicare Explained

A Brief Presentation by

STEPHEN BRUINGTON

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

ObjectiveWhat I’m here to talk about:

Medicare The Low Income Subsidy (LIS) Program MA/MAPD, PDP, and Medigap Policies Commonly Used Healthcare Terminology

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

ObjectiveWhat I’m NOT here to talk about:

Specific Plans Insurance Companies President Obama, or any other member of Congress. Healthcare Reform

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

What is Medicare?Medicare is a Health Insurance Program for people:

age 65 or older. under age 65 with certain disabilities. of all ages with End-Stage-Renal-Disease (ESRD).

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

What is Medicare?Medicare has Two Parts (“Original Medicare”):

Part A (Hospital Insurance)• Most people don’t have to pay a premium for Part A.

Part B (Medical Insurance)• Most people pay monthly for Part B.

• By default, the monthly Part B premium is deducted from your Social Security benefit check.

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

Original Medicare“Original Medicare” consists of Parts A and B:

Run by the federal government. Provides your Part A and/or Part B coverage. You can…

• go to any doctor that accepts Medicare.• join a Medicare Prescription Drug Plan to add drug

coverage.• buy a Medigap (Medicare Supplement Insurance) policy

(sold by private insurance companies) to help fill the gaps in Party A and Part B.

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

Part A (Hospital Insurance)Helps Pay For:

Inpatient hospital care. Critical access hospitals. Skilled Nursing Facility

(SNF). Hospice care. Home healthcare.

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

Part A (Hospital Insurance)Cost (for coverage):

Most people get Part A automatically when they turn 65. They don’t have to pay a premium because they, or a spouse paid Medicare taxes while they were working.

If you don’t automatically get premium-free Part A, you may be able to buy if: • You (or your spouse) aren’t entitled to Social Security

because you didn’t work or didn’t pay enough Medicare taxes while you worked and you are age 65 or older, or

• You are disabled, but no longer get premium-free Part A because you returned to work.

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

Part B (Medical Insurance)Helps Pay For:

Outpatient hospital care. Doctor’s services. Home healthcare. Preventive services.

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

Part B (Medical Insurance)Cost (for coverage):

Most beneficiaries (who were enrolled in Part B during or prior to 2009) will continue to pay the same $96.40 Part B premium in 2010.

For all others, the standard Medicare Part B monthly premium will be $110.50 in 2010.• The cost of Part B may go up 10% for each 12-month

period that you could have had Part B but did not sign up for it, except in special cases. You will have to pay this extra 10% as long as you have Medicare Part B.

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

What is Medicare? (continued)

Medicare has Two Other Parts:

Part C (Medicare Advantage, aka. “MA or MAPD”)• MA/MAPD plans are offered by private insurance

companies. Part D (Prescription Drug Plan, aka. “PDP”)

• PDP are also offered by private insurance companies.

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON

Healthcare TerminologyMedicare and InsuranceCompanies use terms like:

Premium Deductible Co-pay Co-insurance Cost-sharing Out Of Pocket Limit (OOP) In / Out of Network

Medicare Explained

For more information visit www.medicare.gov, or call 1.800.MEDICARE (1.800.633.4227).

A Brief Presentation by STEPHEN BRUINGTON