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Leah Sugar Kari

Here’s some important and frequently asked questions:

How much does Medicare cost? Isn’t Medicare free?

Medicare is not free. If you have worked forty quarters or ten years and have paid Medicare taxes during your employment, your Part A (hospitalization coverage) will be premium free. I f you have not worked forty quarters, you will pay a monthly premium for Part A of $274.00 up to $499. You will pay a monthly premium for Medicare Part B (medical coverage) to have medical coverage in place. The current monthly premium is $170.10 for most beneficiaries, although you may pay a higher monthly premium if your modified adjusted gross income exceeds the amount set by Medicare annually.

How do I pay for Medicare?

If you are claiming your Social Security benefit, your monthly Part B premium will be taken off the top of your benefit. If you are not drawing Social Security when you are eligible for Medicare at 66-years and six-months, for those born in 1957, you will pay your monthly premium on a quarterly basis directly to Medicare. Medicare will bill you and will provide detailed, clear instructions on your payment options. Be absolutely certain this premium is paid on time. Medicare will cancel your Part B medical coverage if your payment for your Part B premium is not made. It is crucial that you check your bank or credit card company to verify payment has been made.

Are there any other costs?

Original Medicare does not limit costs you will pay for care. This is different from Medicare Advantage or Medicare Supplement Insurance Plans. Original Medicare requires you meet a deductible before it pays its share. After Medicare pays, you pay a percent of the cost of care (co-insurance) or a copayment for services and supplies that are covered by Medicare. Medicare will pay its share for a treatment, procedure, or service if Medicare deems it medically necessary. To see what Medicare covers, consult www.medicare.gov for a comprehensive list of services. While Original Medicare does not require a network of providers or referrals, ask if your provider accepts Medicare. A small percentage of providers nationally have opted out of Medicare. This means you are responsible for the entire cost of care provided.

In addition to no limit for Medicare expenses, Original Medicare does not cover prescription drugs. Medicare requires Medicare beneficiaries enroll in prescription drug plans and penalizes those who do not. It is important to investigate your options for care with a Medicare Supplement Insurance Plan (with a stand-alone prescription drug plan) or a Medicare Advantage HMO or PPO plan, which generally include prescription drug coverage. Either option will limit your out-of-pocket costs for your healthcare, an attractive benefit indeed.

Leah Sugar Kari specializes in showing Medicare eligible people their insurance options. Reach Leah for comments at (520) 484-3807 or email leah@leahkarisolutions.com. (TTY users dial 711.)

Leah Sugar Kari, retired pharmaceutical representative, specializes in showing Medicare eligible people their insurance options. Reach Leah for comments at (520) 484-3807 or email leah@medicaresolutionsbyleahkari.com. (TTY users dial 711.)


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