Saturday, October 23, 2010

Understanding Medicare Plans: One Easy Picture

Part A: Hospital Insurance is automatically available to those qualified at no premium. Part A helps cover inpatient hospital and skilled nursing home costs, hospice care and limited home health benefits. There is a large deductible for hospital stays. In 2010, the deductible = $1068 for days 1 - 60 and more for additional days.
Part B: Medical Insurance is a voluntary program that requires a monthly premium. In 2010, this monthly premium was approximately $110. Most Part B recipients have this premium automatically deducted from their monthly social security checks. Part B members pay 20% copay for each doctor visit and medical coverage.
Part D: Prescription Drug Plans offered by private insurance companies that contract with the Federal government to provide these optional plans to medicare recipients for a monthly premium plus copays for each drug's monthly prescription. There is also a large coverage gap once Total Drug Costs reach $2830. This "donut hole" upsets many Medicare members who use large amounts of prescription drugs. They reach the donut hole quickly, especially if they use Brand and Specialty drugs. Then they are stuck paying "out of pocket" until they reach $4850 "out of pocket." Then the price goes down. The good news is, with the new healthcare policy, the donut hole will be closed by 2020.

Part C: Medicare Advantage (MA) Plans are plans offered by private insurance companies that combine hospital and outpatient services into one package for those who are enrolled in both part A and B (MA) and can also include prescription drug coverage (MAPD). Many of these plans have $0 Premiums for both the MA and PD portions of the plan. Many medicare members LOVE MA and MAPD plans because their costs are much lower. $0 Premiums. Lower copays for their doctor visits, hospital stays and prescription drugs. Many people wonder how private Healthcare providers can provide all of these benefits at $0 premiums and lower costs.

Supplemental Plans: Offered by private insurance companies to supplement government offered Part A + B Medicare. They are not compatible with MA plans. They are sold with monthly premiums.


  1. Hey!!! Wait just a doggone minute! Dee said this was a blog about sexy degenerates and it seems to be nothing more than talk about Medicare! What gives? I feel cheated!

  2. Wait just a doggone minute! Dee said this was a blog about sexy degenerates or something like that but all I find is something about Medicare. What gives? Where's the good stuff Dee promised? I feel cheated and sooo confused!

  3. pcorn54,
    Dee is right. This blog is about me and my experience with Medicare. Maybe not too sexy, but it is real. It is honest. It is the truth. It is also a bit scary as I become enlightened about what Medicare is really all about. This is important to me and my family since I will be joining it in about five years.

    You look close to my age. Maybe you know much more than I do about all of this. I've only worked in the healthcare industry for a little over two years now, after I lost my old job and decided to find a new career.

    I decided to go into Insurance. I tested for and received my Texas Insurance Agent license at the ripe old age of 58. I thought there would be jobs and opportunity in this field. Well, at least I am working for now. This blog is about what I have learned and about what I am learning. Medicare and health insurance is so different than I thought.

    Dee is my good friend. We've been friends since we were in school together. She is my sister from another mother. She is much more politically active than I am. We talk for hours on end about our lives, our families, immigration and now about medicare and insurance. She encouraged me to start my blog. now that it is off the ground, I'm glad I did.

  4. Meemaw! I was just jerking your chain. Welcome to the blogosphere.

    Dee is a good friend and she would have expected nothing less of my irreverent first comment on your new blog.

    Congrats, and anything I can help you with, just holler.

    I am at and

    Yes, Dee is a wonderful person and I'm proud to call her a friend.