July 27, 2009

Medicare FAQ

Frequently asked questions on Medicare

What are the Medicare premiums and coinsurance rates for 2009?

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 $244.00 per month for people having 30-39 quarters of Medicare-covered employment.
The Part A premium is $443.00 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

$96.40 per month*

Medicare Deductible and Coinsurance Amounts for 2009:

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 (2009 = $1,068) 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 $1,068 for a hospital stay of 1-60 days.
$267 per day for days 61-90 of a hospital stay.
$534 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

$133.50 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)

$135.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $135.00 deductible.)

What if my monthly Social Security benefit isn’t enough to cover multiple premiums at one time?

If your monthly Social Security benefit isn’t enough to cover multiple premium payments at one time, the premiums won’t be deducted. Your plan will bill you directly and you can pay them directly. You also can arrange with your plan for the premiums to be automatically withdrawn from your checking or saving bank account.

How do I join a Medicare Prescription Drug Plan?

You can join a Medicare Prescription Drug Plan in the following ways:

By paper application. Contact the company offering the drug plan you choose and ask for an application. Once you fill out the form, mail or fax it back to the company.

On the plan’s website. Visit the drug plan company’s website. You may be able to join online.

On this website. You will also be able to join a drug plan at www.medicare.gov by using Medicare’s online enrollment center.  More information is available through our online tool, the Medicare Prescription Drug Plan Finder.

By calling 1-800-MEDICARE. You can join a drug plan by calling 1-800-MEDICARE (1-800-633-4227) and talking to a Medicare customer service representative. TTY users should call 1-877-486-2048.

Do I have to join a Medicare drug plan?

No. Joining a Medicare drug plan is your choice.  However, to have Medicare help pay for your drugs, you must join a plan that provides Medicare prescription drug coverage. You can choose and join the plan that meets your needs. If you don’t use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy.

Will my drugs be covered?

Medicare Prescription Drug Plans must include at least two drugs in every drug category. The plans must also do the following:
(1) Make sure you have convenient access to retail pharmacies;
(2) Have a process for you to get drugs that are not on the list of covered drugs (formulary) when it is medically necessary; and
(3) Provide useful information to you, such as how formularies and medication management programs work, information on saving money with generic drugs, and grievance and appeal processes.

Make a list of all your current medications, including  name, dose size (for example- 2 pills, 300mg in each pill), dosage frequency (for example- 2 times a day) and monthly costs of your current prescriptions. You can use this information to compare the list of drugs (also called a formulary) that are covered under each plan.  You can get the list of drugs a plan covers by calling the plan or by visiting the plan’s website.

For more information, please visit our search tool, the Medicare Prescription Drug Plan Finder.