© 2013-2018 Madigan Insurance Group

Vicki L. Madigan

Independent Benefits Consultant

Medicare Beneficiaries :: Individuals :: Families :: Businesses

Health Insurance Application

Medicare History

In 1965, Congress created Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older. President Lyndon Johnson signed the Medicare amendment into law.

Prior to Medicare only one-half of older Americamedicare card, registration,idns had health care insurance coverage. The percentage was much lower in minority groups.

People under 65, receiving Social Security Disability Insurance, were granted Medicare coverage in 1972.

In 2006 Congress voted to separate the Medicare Part D Prescription Drug plans from the Medicare Supplements/Medigap policies.  All eligible persons who do not receive creditable prescription drug coverage from another plan need to enroll in a Medicare Part D plan to avoid the penalty tax.  Once a person is assessed a penalty tax by Social Security Administration the penalty follows you for your lifetime regardless of who your Medicare Part D coverage is insured by.  The penalty tax is added to the premium you pay the insurance company for your Medicare Part D plan.

In 2010, 48 million Americans received Medicare benefits – 40 million were over 65 and 8 million were under 65 with disabilities.

Medicare, in 2010, only covered 48% of medical expenses

for enrollees. Medicare benefits may be supplemented

with Medicare Advantage or Medicare Supplements/Medigap policies.

Medicare Structure: What are the different parts of Medicare?

PART A:  Hospital Insurance.  Covers inpatient hospital stays, skilled nursing facilities, Hospice care and Home health care.  Has a $1,216 deductible (2014) per benefit period and 20% co-insurance. If you worked forty quarter hours you will have not have a Part A premium.

PART B: Medical Insurance. Covers services from doctors and otherhappy, satisfied, couple, man, woman health care providers, Outpatient care, Home health care, durable medical equipment, and some preventative services.

Has a monthly premium and an annual deductible of $147.00 (2014) and 20% co-insurance.

PART C: Medicare Advantage Plans. Includes all benefits and services covered under Part A and Part B.  Medicare Part C is administered by Medicare-approved private insurance companies. Services may include Medicare Part D Prescription Drug Plans, and may include extra benefits like vision, hearing aids, dental, and health and wellness programs. Part C plans may have premiums, deductibles, co-pays, co-insurance, and provider network limitations.

PART D: Medicare Prescription Drug Coverage.  Medicare Part D helps to cover the cost of prescription drugs. Medicare Part D is run by Medicare-approved private insurance companies, it may help lower your prescription drug costs and help protect against higher costs in the future. Part D plans may have premiums, deductibles, and co-pays based on the tier your drug is classified under.

Medicare Supplements/Medigap Plans

Medicare recipients may opt to minimize their financial risk of being enrolled in only Original Medicare by purchasing a Medicare Supplement Plan. These insurance policies are standardized by Centers for Medicare & Medicaid Services (CMS). Most premiums are paid on a monthly basis and rates/premiums are determined by the person’s age, zip code, and tobacco usage.

Medicare Advantage

Medicare Advantage comprises a variety of private health plans – most often HMO’s, HMO-POS, PFFS, MSA’s and PPOs – that Medicare offers as another option to Original Medicare or Medicare Supplementsman, woman, bicycle, bike path. All Medicare Advantage (Part C) plans must cover all the same benefits that Original Medicare covers. The monthly premium may vary by geographic region and the insurance provider. Medicare Advantage Plans may include: deductibles, co-pays and co-insurance of the Medicare approved amount. Medicare Advantage Plans may require the insured to stay with-in the network, except in the case of an emergency, and you may need a referral to see a specialist. Most Medicare Advantage plans have an annual out-of-pocket maximum to help minimize the financial risk for a consumer.  Many plans include prescription drug coverage at no additional cost.  If you enroll in a Medicare Advantage health plan, you cannot, by law, also be enrolled in a Medicare Supplement/Medigap policy, or have coverage by a Union or other employer. You may only be enrolled in one plan at a time.

Vicki Madigan is a licensed insurance agent in Illinois

and Wisconsin. She is authorized

and certified to offer you insurance products

in Medicare Supplements/Medigap policies, Part D

Stand Alone Prescription Drug plans,

and Medicare Advantage Plans.

Individual home appointments are recommended

to analyze your specific healthcare needs

and find the best plan that gives you

the most comprehensive health care coverage

at the lowest out-of-pocket costs.

Schedule your appointment today. Call (847) 457-1802