Hynes & Chu, LLP * {attorney advertising}

Traditional Medicare Program
Home Page
About Our Firm
Lawyer Profiles and Staff
Areas of Expertise
Speaking Engagements
Medicaid Eligibility
Medicaid Choice: The New Medicaid Managed Long-Term Care Program effective 9/17/12
Medicare Information
Medicare Part D Prescription Drug Coverage
Help paying Medicare out of pocket costs
Medicare Advantage Plans - Look Before You Leap
Basic introduction to Long Term Care Insurance
Articles and Publications
Elderly Pharmaceutical Insurance Coverage Program (EPIC)
The "New" Health Care Reform Act and what it means for you.
Directions to Office
Contact Us
In The News

When is the best time to file for Medicare? - to read a useful article by Bankrate, Inc. in answer to this question click on the link below.

**Click Here** to be taken to Bankrate, Inc. article on when to file for Medicare.

Medicaid planning is used to prepare for or deal with the end of Medicare benefits.  The information provided below will help you determine when or if your Medicare benefits will end and when you may need to look into the need for Medicaid coverage to help pay for the high cost of long term care.
***Note: When a person is recieving Medicaid benefits, they continue to be covered by Medicare - however, Medicaid becomes "secondary" health insurance.
Traditional  Medicare is the health insurance program administered by the federal government.  It permits you to see any doctor who will accept you as a patient.  It provides hospital and medical insurance for:
  • People 65 years
  • Disabled individuals (24 consecutive months)
  • People with End-Stage Renal Disease (ESRD)
  • Spouses of eligible workers, certain divorced persons, widows and widowers, and dependents

Medicare consists of two parts:

  • Part A - hospital insurance - helps pay for inpatient hospital, skilled nursing facility rehabilitation care and some home health care.
  • Part B - medical insurance - covers physician services, outpatient hospital care, durable medical equipment, ambulance service and lab tests. 
  • Part A and Part B have deductibles and coinsurance (see below)

Eligibility is automatic if you are collecting Social Security retirement benefits.  Part A is free if you have worked at least 10 years (40 quarters of Medicare-covered employment).  Part B has a monthly premium. 

 If you have not worked at least 10 years, you may be eligible to buy Part A coverage: In 2016, for people having 30-39 quarters of Medicare-covered employment, the monthly premium is $226. For people having less than 30 quarters of Medicare-covered employment, the monthly premium is $411.

Part A - Medicare and Inpatient costs 2017 (Acute hospital care; limited coverage for skilled nursing home, hospice and home care. No private duty nursing, no TV and no telephone; private room only if medically necessary)

Days

Medicare Pays

Patient Pays (Co-insurance)

1 through 60

Everything after deductible is paid

Deductible of $1,316.00 is owed (no coninsurance)

61 through 90

Everything after Co-Insurance is paid

Daily Co-Insurance of $329.00

91 through 150   {life time reserve days - once per life-time}

Everything after Co-Insurance is paid

Daily Co-Insurance of $658.00 

151+

Nothing

All costs**

.

.

**Supplemental insurance can help cover costs

Print

Part A - Skilled Nursing Home Rehabilitation 2017
(Ongoing coverage beyond the first 20 days is subject to patient's ability to benefit from continued therapy and exhibit medical improvement.  When patient becomes a chronic care patient all Medicare coverage is discontinued)

Days

Medicare Pays

Patient Pays

1 through 20

Everything

Nothing

21 through 100

Everything after Co-Insurance is paid

Daily Co-Insurance of $164.50

101+

Nothing

All costs

.

.

**Supplemental insurance can help cover

Print

Part B - Premiums / Deductible 2017
(Limited coverage for physicians, outpatient services, diagnostic tests and durable medical equipment)

 

  • Monthly Premium: $134.00 per month if yearly income is $85,000 or less, **Higher-income consumers pay more. If premium is dedicted from your Social Security check, then premium is reduced ; you then pay $109 on average.

Part D - Prescription Drug Coverage :

**Click Here** to be taken to our page explaining Part D Medicare

The Medicaid Program offers "special help" to pay for Medicare premiums, co-pays and deductibles for low income individuals. **click** to be taken to our web page explaining these benefits.

To visit the official government Medicare web site click here to go to www.Medicare.gov.

For your other questions about the Medicare program, click here to go to the MEDICARE RIGHTS CENTER web page.

Click here to take Kiplinger's "Making Sense of Medicare" quiz - learn what you do and don't know about Medicare.

To read an article about 10 things that Medicare will probably not cover CLICK HERE.

 copyright - Hynes & Chu, LLP - 2017