The Medicare Project   
a consumer's guide to Medicare Information resources

topics in this section: Medicare Part A, Medicare Part B, Medicare Insurance, Benefits, Coverage

Medicare Part A Medicare Part B The Medicare Project Home

Medicare Basics: Part A & Part B Coverage
Web pages and brochures that explain how basic Medicare coverage - Part A and Part B - provide coverage towards your hospital and medical expenses.

This is one section of The Medicare Project, a series of consumer directories that help seniors through the maze of Medicare information in the hundreds of pages at government and private websites. Our editors have chosen these recommendations to help you find answers to questions about Medicare insurance and coverage. This section focuses on Medicare Part A, or Medicare hospitalization coverage, and Medicare Part B, which is Medicare medical coverage.

Medicare Part A

Think of Medicare Part A as "hospital insurance". It pays towards your expenses for hospital care (inpatient), a skilled nursing facility (but usually not including long-term-care), some aspects of home health care and, if you need it, hospice.

Medicare Part A and Part B is not Prescription Drug Coverage or Insurance.

According to the federal Centers for Medicare & Medicaid Services*, "Most people automatically get Part A coverage without having to pay a monthly premium because they, or their spouses, paid Medicare taxes while working." You must meet certain qualifications to get these benefits. If you do not qualify, you might be able to buy Medicare Part A. Your red, white and blue Medicare card should list it if you were automatically enrolled in Part A.

*U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244-1850 - www.medicare.gov

Web pages and brochures from government, education, and non-commercial sites about these subjects:

web page:
Part A Benefits & Costs 2005

source:New York State Office for the Aging
languages: English
from the web page: (date:2005) "...Medicare Part A is financed primarily through federal payroll taxes (FICA taxes) paid into Social Security by employers and employees. The FICA tax is 7.65 percent. Of this, 1.45 percent goes to the Medicare Part A Trust Fund. The rest of Part A is paid for by people who must purchase it. Medicare Part A Covered Services and Costs ... "

web page:
Medicare Program - General Information Overview

source:Centers for Medicare & Medicaid Services
languages: English
from the web page: "...Part A Hospital Insurance - Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits... "

how to use this data
web page:
How to Read Your Medicare Summary Notice (MSN) - Part A

source:Medicare.gov - The Official U.S. Government Site for People with Medicare
languages: English, Spanish
from the web page: "...Below is a sample Medicare Summary Notice (MSN) for Part A services and information on how to read it. The MSN is not a bill. Do not send money to Medicare or to the provider until you get a bill..."
 
more from Medicare.gov - The Official U.S. Government Site for People with Medicare:
web page:
Medicare Premium Amounts for 2007
languages: English
from the web page: "Part A: (Hospital Insurance) Premium

Most people get Part A automatically when they turn age 65. They do not have to pay a monthly payment called a premium for Part A because they or a spouse paid Medicare taxes while they were working..."



Medicare Part B

Part B is the basic coverage for medical expenses such as doctor's fees, some exams and tests, certain outpatient care in a clinic or hospital, and approved screening shots. These are basic services not covered under Medicare Part A. It usually does not pay 100% of a specific cost: it pays the Medicare share, and you must make up the difference.

Medicare Part B is optional; you must sign-up for it. It is frequently called the traditional or original Medicare plan. You could purchase the coverage alone, as Part B insurance, or add to it with insurance that gives you expanded coverage for medical expenses, and as another option, prescription drug costs. (see our links to Medicare Advantage and Prescription Drug Plans on our home page The Medicare Project - home)

The cost for Medicare Part B is set by a standard monthly premium that applies to everyone below a monthly income limit set by the federal government.


web page:
Medicare Part B Premiums: New Rules For Beneficiaries With Higher Incomes

source:Social Security Online
languages: English, Spanish
from the web page: (October 2006) "...A new law is changing how Medicare Part B premiums are calculated for some higher income beneficiaries. The majority of Medicare beneficiaries will not be affected. Part B (medical insurance) helps pay for doctors’ services and outpatient care. It also covers other medical services, such as physical and occupational therapy, and some home health care...."
 
also from Social Security Online:
web page:
Medicare Part B Premiums: Important Information For People Newly Eligible For Medicare
languages: English, Spanish
"If you are age 65 or older and are now filing for Medicare, you automatically will receive Medicare hospital insurance (Part A). You then will need to decide if you want Medicare medical insurance (Part B)...."

web page:
Medicare Part B Premiums: New Rules For Beneficiaries With Higher Incomes Frequently Asked Questions
languages: English, Spanish
"A new law is changing how Part B premiums are calculated for some beneficiaries..."

web page:
Medicare Plan Choices

source:AARP
languages: English, Spanish
from the web page: "...you may have a choice of how you get your health care in Medicare. You can always choose the Original Medicare Plan, open to everyone with Medicare. Or, you may be able to choose a Medicare Advantage Plan. Medicare Advantage Plans are health plans offered by private insurance companies that provide you your Medicare benefits..."
 
more from AARP:
web page:
Original Medicare: Doctor, Home Health and Preventive Care
languages: English
from the web page: "Medicare Part B helps pay for doctor bills, some home health care, certain preventive services, outpatient hospital care, medical equipment and supplies, laboratory services, x-rays, physical therapy, mental health services, ambulance services, and blood. It does not pay all of these costs. You must pay some of these costs too..."



web page:
Medicare Part B monthly premiums in 2007 - How much are the 2007 monthly premiums for Medicare Part B?

source:Centers for Medicare & Medicaid Services FAQ's
languages: English
from the web page: "Starting January 1, 2007, Your Part B Premium will be Based on Your Income... Most people will pay the standard monthly Part B premium of $93.50 in 2007. Some people will pay a higher premium based on their modified adjusted gross income...


web page:
Substantially Higher Part B Premiums in 2007 As Medicare Means Testing Starts

source:The Senior Citizens League
languages: English
from the web page: "For the first time in Medicare's history, millions of seniors will be required to pay substantially more for their Medicare Part B premiums than other seniors next year. In 2007 the government will begin "income relating," or means testing. Higher income seniors will have to pay more for their doctors' services and outpatient coverage. The change, which comes as part of the 2003 Medicare drug legislation, could affect as many as 2.3 million seniors according to estimates by the Congressional Budget Office (CBO)...


web page:
Medicare Part B Premiums To Increase 11.2% in 2007 to Nearly $100 Per Month, Bush Administration Says

source:Kaiser Daily Health Policy Report
languages: English
from the web page: [Jul 12, 2006] "The monthly premium for Medicare Part B will increase a projected 11.2% next year to at least $98.40, although the increase might be slightly higher, the Bush administration announced on Tuesday, the AP/Seattle Post-Intelligencer reports...


Medicare brochure or publication:
Medicare and Other Health Benefits: Your Guide to Who Pays First

source:Federal Citizen Information Center of the U.S. General Services Administration
file size:40 pg.   languages: English
from the brochure:"This Guide explains how Medicare works with other kinds of insurance or coverage, and who should pay your bills first. Some people who have Medicare have other insurance or coverage that must pay before Medicare pays its share of your bill. You may have more than one type of insurance or coverage that will pay before Medicare...."
 
more from Federal Citizen Information Center of the U.S. General Services Administration:
web page:
The Facts about Medicare’s New Preventive Benefits
languages: English
from the web page: "Starting January 1, 2005, Medicare will cover these three new preventive benefits:
• One-time “Welcome to Medicare” physical exam for people new to Medicare • Cardiovascular screening • Diabetes screening..."



web page:
How to Read Your Medicare Summary Notice (MSN) - Part B

source:Medicare.gov - The Official U.S. Government Site for People with Medicare
languages: English, Spanish
from the web page: "Below is a sample Medicare Summary Notice (MSN) for Part B services and information on how to read it. The MSN is not a bill. Do not send money to Medicare or to the provider until you get a bill..."


web page:
Federal Employees Health Benefits Program Medicare and FEHB FAQs

source:U.S. Office of Personnel Management
languages: English, Spanish
from the web page: "Medicare Part B Coverage
* Do I Have to Take Part B Coverage? * How Much Does Part B Coverage Cost? * What Happens If I Don't Take Part B as Soon as I'm Eligible?"



web page:
Medicare: Part A & B

source:University of Iowa Hospitals and Clinics
languages: English, Spanish
from the web page: "...Medicare Part B is optional and requires a monthly premium. It covers certain medical and outpatient services, including physician care. The premium varies and there is an annual deductible. After the deductible is met, Medicare B will pay 80 percent of Medicare- approved charges for covered services. You are responsible for the remaining 20 percent of the Medicare approved charges..."


web page:
Got Medicare sign-up headache? Here's help

source:The Seattle Times
languages: English
from the web page: "Q: I saw an ad for a Medicare Advantage plan with free monthly premiums. What's the catch?
A: It's not quite "free," because the government will still be deducting your Medicare Part B premiums for physician services (slated to rise to $96.40 a month starting next year) from your Social Security checks. The premiums for private Medicare plans pay for extra benefits you don't get with traditional Medicare...."



 

 

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