Toni King will be hosting a workshop called "Confused About Medicare" to help explain Medicare and provide guidance to those new to the program. The workshop materials provide an overview of Medicare including: how to get your welcome kit and enroll in parts A and B; rules for enrollment and penalties for late enrollment; what each part covers and costs; important dates for enrollment periods; supplements and advantage plans; prescription drug coverage and the donut hole; and ways to get more information through a DVD, CD, or newsletter.
2. “To Do” List for People
New to Medicare
Make sure you get your “Welcome Kit”
from Medicare 3-4 months prior to
turning 65 or if under 65, when
you are approved for Medicare
Make sure you have Medicare “Part B”
(Medical Care) on your Medicare
Red, White and Blue Card
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3. Rules For Enrolling in Medicare
When enrolling in Part B you have an initial 7 month window, 3 months before you
are eligible for Part B, the month of, and 3 months after. If you do not enroll in Part B
when you are eligible and want to enroll later you will be penalized 10% each year
you could have been on B but did not enroll.
3 year wait=3x10% or 30% each month forever…
Currently Part B premium is $104.90 so that would be $104.90 plus 30% each month
of that year!!!
4. Medicare Parts A
Work 10 years
Or 40 quarters
For $0 premium
Part A (Hospital Insurance)
$
deductible
6 times a year
60 day benefit
Pays .…. the Hospital
….. Some cost of Skilled Nursing
….. Hospice
……Home Health Care
Pays Nothing for
….. Long Term Care
….. Out Patient Services
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5. MEDICARE Part B
(Medical Insurance)
Monthly
Premium
$
$
deductible
once a year (1 time)
Medicare pays 80%
You pay 20%
What Part B pays for:
… Medically necessary services
… Doctors, tests,
… Outpatient care and
… Preventative services
6. How Long Has It Been
Since You Have Had A
Medicare Review?
Why Do You Need A
Medicare Review?
$$$$$
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7. Medicare Supplement or Medigap Policies
Medicare Supplement is the best there is!
•
•
•
•
•
•
You must have Part A and Part B
Enroll at the right time to get Guaranteed Issue!
Works only with Original Medicare (your Red, White and Blue Card)
The cost goes up each year!
A supplement does not have Part D Medicare Prescription Drug Plan
Must enroll in a Medicare Prescription Drug Plan to have drug coverage
$
$ $$$$ $
$
$
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8. KNOW YOUR ENROLLMENT DATES
Annual Election Period
October 15 – December 7th this year!!
Anyone can enroll into a Medicare
Advantage Plan OR make changes to
another Medicare Advantage Plan.
Anyone with a Medicare Prescription
Drug Plan CAN ONLY change
during this period
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9. Medicare Part C
Part C (Medicare Advantage Plans)
(covers the headaches caused by Parts A, B, D
A way to have your Part A and Part B deductibles
and Co-pays paid.
But you must obey the RULES
RULES
Rule
RULE – You must stay in network
and use their doctors
RULE – DO NOT use your Red, White and Blue
Rule
Medicare card
Rule – OBEY THEIR RULES
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10. Medicare Part D
(Prescription Drug Plans)
Helps cover prescription drug costs
Has Co-pays and most important
the DONUT
HOLE!!
Must enroll at the RIGHT time
or you will be PENALIZED
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11. What is the “Donut Hole”????
The “Donut Hole” starts at $_____.00 and you must spend
$______.00 out of your pocket to get back into your plan!
Confusing … I know!!!
Monthly Copay
what Mary paid
Insurance Company Pays
Total Drug
Cost
January
$416.00
$520.00
February
DONUT HOLE
$104.00
$208.00
$832.00
$1,040.00
March
$312.00
$1,248.00
$1,560.00
April
$416.00
$1,664.00
$2,080.00
May
$520.00
$2,080.00
$2,600.00
June
$654.00 plus
$2,186.00
Mary gets in the donut hole
$2,970.00
July
$1,174.00
August
$1,694.00
September
$2,214.00
October
$2,734.00
November
$3,254.00
December
$3,774.00
Mary will never get into catastrophic coverage.
Mary never
Mary never
Marynever
gets out of
gets hole! of
gets out of
the out
the HOLE!
the HOLE!
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12. YOU PAY
%
DRUG CO. PAYS
%
of CERTAIN brand name drugs
until you reach
$______
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