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OHIO MEDICARE PLANS 

Buckeye Senior Benefits Agency

What is Medicare Part A and B and What Does it Cover?

 
MEDICARE 
PART A - HOSPITAL INSURANCE
PART B - MEDICAL INSURANCE
What is it?
Medicare Part A is a government-run type of hospital insurance that covers hospital, skilled nursing facility, hospice, and home health services.
Medicare Part B is a government-run type of medical insurance that covers doctor and non-physician professional services, outpatient care, and other medically necessary expenses.
Who is Eligible?

  • Most individuals automatically get Part A coverage without having to pay a Part A premium due to paying into during their working years.
  • Individuals with disabilities who are under age 65 are automatically enrolled in Part A after they have received Social Security or Railroad Retirement disability benefits for 24 months.


  • Most individuals who file an application for Social Security benefits 3 months before they turn age 65 or later are automatically enrolled in Part B unless they refuse Part B coverage.
  • Individuals with disabilities who are under age 65 are automatically enrolled in Part B after they have received Social Security disability benefits for 24 months.


How Much Does it Cost?
  •  Nothing – if you have paid Medicare taxes while working. This is also known as “Premium Free Medicare Part A”. To enjoy Medicare Part A free you or your spouse should have worked for at least 40 quarters of a year, i.e. 40 x 3 months = 120 months.
  • For those individuals who do not automatically qualify for Part A coverage, the monthly Part A premium in 2015 is $224 up to $407.
  • For Part B majority of seniors pay the monthly premium $104.90 (2015)
  • Individuals with income over $85,000, or filing jointly with incomes over $170,000, pay more, up to $335.70 a month in 2015 based on the income related monthly adjustment amount (IRMAA).
How Do I Enroll?
Retirees are automatically enrolled when they turn 65 or have been disabled and receiving benefits for 24 months.
Retirees are automatically enrolled when they claim Social Security retirement benefits. If they do not want the coverage due to group health coverage they can send their card back and opt out for the time being.
What Does it Not Cover?
(BEWARE!)
  1. Please remember that Original Medicare covers Hospitalization after a $1,260 deductible for the first 60 days, after that it's $315 coinsurance per day for days 61-90 of a hospital stay. A Medicare Supplement Plan could tremendously help cover those costs with a monthly premium of $75-$175 a month depending on age and tobacco use. For more information visit our Medigap PAGE.
  2. Also, DO NOT FORGET, neither Medicare Part A coverage or a Medigap plan will pay for Nursing Home stays (custodial care). Only a Long Term or Short Term Care plan can do that. For more information visit our LTCi PAGE.
  1.  Please remember that Original Medicare covers 80% of approved Medicare charges for any Part B expense. It is your job to pay the other 20% coinsurance. One way to cover those costs is with a Medicare Advantage plan where a doctor's visit can be a copay ranging from $0 -$40 (deductibles may apply). For more information on Medicare Advantage plans visit PAGE.
  2. Also DO NOT FORGET, Part B Medicare insurance nor a Medicare Supplement (Medigap) plan will cover Dental, Vision, or Hearing services. In order for you to get coverage for those services you will need a Medicare Advantage plan that covers that or visit our COMBO Dental,Vision, and Hearing plan PAGE.