2018 medical insurance terms and changes

Medicare is available to US citizens or legal permanent residents aged 65 and over. In addition, you or your spouse must work for 10 years [40 quarters]. Some people under the age of 65 are eligible for health insurance if they have certain disabilities and meet the guidelines.

The government provides Medicare A and B.

Part A

Most people don't pay extra for Part A, including hospital hospitalization, professional care, family health and hotel care, because when you work, you have paid for it. Deductibles and co-insurance of approximately $1,316.00 will be available after 60 days.

Part B

This is health insurance, covering doctors and other health care provider visits, outpatient care, home care, durable medical equipment and some preventive services, rather than hospital care. The premium is approximately $134.00 and the deductible is $183.00. Part B is designed for the government to pay about 80% of medical expenses.

Part C

This is called Medicare Advantage, which combines Part A and Part B and adds additional benefits, perhaps prescription drug coverage [Part D] and dental or vision coverage. They can be zero premium [you still have to pay Medicare premiums] or an extra fee based on benefits.

Part D

Private insurance companies cover the Medicare prescription drug program, which ranges from about $15.00 to $100.00 per month. Each of them has an approved list of drugs.

Medical insurance options and supplements

Since Medicare does not include all health care costs, these policies [called Medigap] cover some or all of the costs not covered in Parts A and B. However, these plans do not include drugs and there are additional costs for Medicare Part A and Part B.

Many people choose these combinations to get the most comprehensive coverage. E.g:

• Medicare supplement plan with Medicare Part A and Part B and Part D [for prescription drugs]
• Medicare offer plan [part C] with Medicare Part A and Part B, most Part C plans include Part D [covering prescription drugs]

Other medical insurance facts

• You cannot have both a Medicare grant and a Medicare Advantage program.

• You can change your Part C or Part D plan annually from October 15, 2017 to December 7, 2017 for the 2018 annual registration period.

Part B premiums for 2018 are:

• $ 1340.00 / month: less than $ 85,001 [single] / less than $ 170,001 [married]
• $ 187.50 / month: $ 85,001- $ 107,000 [single] / $ 170,001- $ 214,000 [married]
• $ 267.90 / month: $107,001- $ 133,500 [single] / $ 214,001- $ 267,000 [married]
• $ 348.30 / month: $ 133,501- $ 160,000 [single] / $ 267,001- $ 320,000 [married]
• $ 428.60 / month: more than $ 160,000 [single] / more than $ 320,000 [married]

Some people eligible for Medicaid [another government program] may only be eligible for QMB [Qualified Health Insurance beneficiary] status. This means they can get help with Medicare insurance premiums and deductibles, co-insurance or co-payments. However, with this status, you cannot afford other health costs. Medicare approved providers may not charge QMB status personnel, but state Medicaid may pay for these fees.

Please also note that if Medicare rejects the charge instead of underwriting the service, the supplemental insurance will also be rejected. An example is a person who transports an ambulance to a doctor's office. Medical insurance denial is not covered, and secondary insurance is also denied. The balance is the responsibility of the patient, or the patient can provide a medical record to provide medical necessities for transportation.

Although you may get better insurance than before, the Medicare maze is still something you must pay attention to. Double check your bills and Medicare summary notices and take steps to reconsider your claim before your expiration date expires.

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