Time to review Medicare basics
December 5, 2019
By: Doug Sheaffer
Email: doug.sheaffer@dshs.wa.gov
Annually—at least—it becomes a good idea to try and create a cheat-sheet about Medicare basics. Given the increase of “You-can-get-everything-you-want-plus-services-you-didn’t-even-know-about-with-no-extra-costs” ads drowning the networks, things can be a bit confusing.
In a recent column, I noted these ads (including dog walking which was just for fun) are aimed particularly at those who are new to Medicare or are looking at changes in their life.
I was reminded (again) of their pervasiveness just recently when I overheard a gentleman ask the counter person in a drug store about advantage plans in our area. Simply put, there are no Advantage (Part C) Plans in our county.
It becomes particularly blurry during open enrollment periods and political posturing. Yes, Medicare can be complicated. No, it’s not rocket science (it’s sometimes less intuitive) but it does have levels of information and is, of course, keyed to individual needs.
I was asked at one point, to reprint a quick summary of what the Medicare parts are and what they cover. Glad to oblige:
- Part A: Hospital coverage. Which generally covers in-patient care, nursing services (not long-term care in a facility), home health services, hospice services, etc.
- Part B: Outpatient Services. Clinics, doctor visits, tests, physical therapy and other services. Part B comes with a premium, which starting in 2020 is $144.60 for most of us and usually overs about 80% of the costs. There are supplemental or medi-gap plans that can be purchased to fill the gap, and there are low-income programs that may help pay the Part B premium.
- Part C: Advantage Plans. See above: There are no Advantage Plans available in Pacific County.
- Part D: Prescription coverage for Medicare recipients are through private insurance companies, so premiums and formularies differ. Though somewhat under Medicare, the plans can change dramatically from year to year. As with Part B, there are some low-income programs that might help with costs.
So—go ahead and clip the middle part of this column and attach to your fridge, laminate for your wallet or whatever. (I wouldn’t recommend a tattoo, because the standards do change.)
One quick reminder: Medicare Part D open enrollment closes December 7th, so if looking for change, not a lot of time left.
Enjoy!
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