Medicare Basics

 

Medicare beneficiaries with Part A and/or Part B are eligible to receive outpatient prescription drug coverage under Medicare Part D. In addition to the voluntary drug benefit, new preventive care services have been added to the overall benefit package to reflect the way medicine is practiced today. The law creating these new benefits in Medicare were signed into law by President Bush on December 8, 2003.

Whether you decide stay in traditional Medicare or choose a PDP, or a Medicare Advantage Plan, is completely up to you.

Most people have saved $1000 onaverage on their prescription drug costs. Many people will also be eligible for further assistance. If you receive a letter from the Social Security Administration, we encourage you to complete the form and return it for processing.

 

What are the Medicare premiums and coinsurance rates for 2011?

The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2011:

Medicare Premiums for 2011:

 

Part A: (Hospital Insurance) Premium

  • Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.

  • The Part A premium is $248.00 per month for people having 30-39 quarters of Medicare-covered employment.

  • The Part A premium is $450.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

Most beneficiaries will continue to pay the same $96.40 or $110.50 premium amount in 2011.  Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium in 2011.  For additional details, see our FAQ titled: "Will my Medicare Part B premium increase in 2011?"

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium.  The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs.  If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month.  For additional details, see our FAQ titled: "2011 Part B Premium Amounts for Persons with Higher Income Levels".

Medicare Deductible and Coinsurance Amounts for 2010:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2011 = $1,132) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

  • A total of $1,132 for a hospital stay of 1-60 days.

  • $283 per day for days 61-90 of a hospital stay.

  • $566 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).

  • All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

  • $141.50 per day for days 21 through 100 each benefit period.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

  • $162.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $162.00 deductible.)

Additional information about the Medicare premiums, deductibles, and coinsurance rates for 2011 is available in the November 4, 2010 Fact Sheet titled, "Medicare Premiums, Deductibles for 2011" on the www.cms.gov website.

Information for Veterans on the Medicare Prescription Drug Benefit

Quick facts about Medicare Prescription Drug Coverage: If you have limited income and resources

 

 

 

 

 

 

 

 

  • Additional Resources

    BenefitsCheckupRx.org assesses current prescription drug coverage and tells beneficiaries what their rights and options are based on their situation.

    The National Alliance for Caregiving is dedicated to providing support to family caregivers and the professionals who help them and to increasing public awareness of issues facing family caregivers.

    Medicare Prescription Drug Improvement and Modernization Act of 2003: Frequently Asked Questions

    Further Help with Your Medicare Questions? - The State Health Insurance Assistance Program (SHIP) has counselors in every State and several Territories that are available to provide free one-on-one help with your Medicare questions or problems.

    Assistance for Medicare Beneficiaries with Limited Income and Resources - U.S. Social Security Administration

    Find prescription savings programs using the Medicare Prescription Drug Benefit Calculators - Access to Benefits Coalition

     

     

     

     

     

     

     

     

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    Fax           (925) 866-1860
    info@californiahealthinsurance.com
     
    American Compensation Service, Insurance Services, San Ramon, CA