The total cost to you will vary depending on a number of factors, such as how often you go to the doctor, if you are under continuing care, use a lot of prescription drugs, and many other factors. The basic costs are as follows:
• Part A: In most cases there is no cost. As long as you or your spouse have paid taxes for at least ten years you are eligible.
• Part B: In 2005 the monthly premium is $78.20. If you do not sign up during your seven-month enrollment period you may have to pay more for Part B the longer you wait to enroll. There is a $110 deductible with Part B, which means that you pay that amount out of pocket before any Part B benefits begin.
How do you enroll?
There is a seven-month enrollment period, starting 3 months before your 65th birthday. In many cases people are enrolled automatically. In order to enroll, contact the Social Security Administration at 1-800-772-1213.
What if I want more coverage?
It is possible to have private or group coverage (such as a retirement benefit offered from your employer) in addition to Medicare. This could provide additional benefits to both Part A and Part B; it will most likely cost more, as you would normally be paying a premium for both Medicare and your other plan. There are a number of items to consider when making the decision to get additional coverage.
• Medigap: A Medigap Plan, sometimes called a Supplementary Plan, is designed to fill the gaps left by Medicare. For example, if you have only Medicare and are presented with a $5,000 doctor bill, Medicare will cover (after your deductible is met) 80%, or $4,000, leaving you with a $1,000 bill. If you have a Medigap plan, it covers the other 20%, so the entire $5,000 bill is taken care of.
• Secondary Insurance: In the event your insurance plan is not a Medigap Plan, it will operate as a Secondary Insurance plan. While Coordination of Benefits (who pays what) is always resolved between insurance companies, it is important to know the potential impact to you. A Secondary plan typically receives the bill after the Primary plan (in this case, Medicare) pays their portion. So far, this is just like a Medigap. The difference is in how the Secondary Plan looks at the bill. If your Secondary Plan covers a certain service at 80%, and Medicare covers it at 80% and has paid their portion, then the 80% has been met and your Secondary Plan will pay nothing. In the above example of a $5,000 doctor bill, you are back to paying $1,000 (in addition to the extra premiums for the Secondary Plan.)
• So what do I do?: Talk to your plan. Find out what they will pay in a number of different circumstances. Get concrete answers. There may be good reasons to carry a second plan, even if it isn’t a Medigap, such as a decent Prescription Drug program.