Medicare Gals: Medicare Basics (Parts A, B, C and D)
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The document provides biographical information about Sondra Ford and Mary Dorn who work for Trusted Senior Specialists and information about the company. It then outlines topics that will be covered in an upcoming presentation on Medicare, including what Medicare is, its different parts, what is and isn't covered, premiums and costs. The presentation will review these topics, take questions, and invite people to future presentations and one-on-one meetings with specialists.
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Medicare Gals: Medicare Basics (Parts A, B, C and D)
- 2. ABOUT THE MEDICARE GALS Sondra Ford Compliance Officer •Native Houstonian. •Has been in the Insurance Industry since 2007. •Field agent with Trusted Senior Specialists since 2009. •Experienced in call center and now compliance. •Has a 2-week University child, and one that just turned 2. Mary Dorn VP of Agent Support •Originally from Ohio, moved to Texas in 1990. •Insurance Agent, licensed in many states. •Has been helping our community since 2008. •Has been with Trusted Senior Specialists since 2002. •Is a Grandmother of 4, 3 girls and 1 boy.
- 3. ABOUT TRUSTED SENIOR SPECIALISTS We began in Texas over 13 years ago and are now in 40-plus states across the country. As members of the Better Business Bureau, we have an A+ rating and have been honored as a Winner of Distinction at the 2011, 2012, 2013 Awards for Excellence. For the past decade, we have established a name and reputation based on reliable service, honesty, integrity and have built an Insurance Marketing Organization of over 3,000 agents in 42 states. We are dedicated to assisting families, groups and individuals with their different insurance needs such as: Life Insurance, Health Insurance, Final Expense, Long Term Care and Cancer. We specialize in Medicare Supplements and Medicare Advantage Plans. www.TrustedSeniorSpecialists.com www.MedicareGals.com
- 5. TOPICS FOR TODAY 1. 2. 3. 4. 5. WHAT IS MEDICARE? MEDICARE PART A MEDICARE PART B WHAT IS NOT COVERED PREMIUMS, DEDUCTIBLES, CO-INSURANCE: HOW MUCH DOES MEDICARE COST? 6. QUESTIONS 7. PRESENTATION REVIEW 8. OPEN INVITATION!
- 6. WHAT IS MEDICARE? • WHAT IS MEDICARE? • WHO IS ELIGIBLE • WHAT ARE THE DIFFERENT PARTS OF MEDICARE
- 7. WHAT IS MEDICARE? Medicare is a Federal Health Care Program for: • PEOPLE AGE 65 AND OLDER • PEOPLE YOUNGER THAN 65 WHO ARE DISABLED • PEOPLE YOUNGER THAN 65 WHO HAVE END-STAGE RENAL DISEASE (ESRD) NOTE: People under 65 must have a disability and have Collected Social Security Disability for at least 24 months Before they qualify for Medicare; however there are exceptions.
- 8. WHAT IS MEDICARE? There is no waiting period for those with: •Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig’s Disease) •Kidney Failure: End Stage Renal Disease (ESRD) Medicare is administered by the Centers for Medicare and Medicaid Services (CMS). Enrollment into Medicare Parts A&B is handled by the Social Security Administration (SSA).
- 9. WHAT IS MEDICARE? What are the different parts of Medicare? Part A – Hospital Insurance Part B – Outpatient Medicare Insurance (Doctors) Part C – Medicare Advantage Plans Part D – Prescription Drug Plans
- 10. MEDICARE PART A • • • • Inpatient Hospital Care (Up to 150 days for a lifetime) Psychiatric Hospital Care Skilled Nursing Facility Home Health Care; Intermittent Skilled Care Prescribed by a Doctor • Hospice; Pain Management Program for those who are Terminally Ill • Blood; Does not include the first 3 pints. Blood must be received during hospital stay or skilled nursing facility stay)
- 11. MEDICARE PART B • • • • • • Physician Visits Diagnostic Testing Rehabilitation Services Durable Medical Equipment Ambulance Services Limited Benefits include Mental Health, Outpatient Physical Therapy, Occupational Therapy, and Speech Therapy
- 12. WHAT IS NOT COVERED? In order to be covered by Medicare, all Part A and Part B services must be medically reasonable and necessary. There are some services that are NOT covered including: •Routine Dental Care •Routine Eye Exams •Routine Hearing Care •Routine Foot Care (Exception: Some foot care is covered for diabetics) •Acupuncture
- 13. PREMIUMS, DEDUCTIBLES, CO-INSURANCE Part A Premium (2014): •If you or your spouse have worked for 40 quarters: $0 per month •30-39 quarters: $243 per month •Less than 30 quarters: $426 Part A Deductible (2014): •$1216. (This can happen several times throughout the year and covers hospitalization costs for days 1-60) Part A Co-Insurance (2014): •Days 61-90: $304 per day •Days 91-150: $608 per day NOTE: There is no catastrophic limit on Out-of-Pocket expenses with Original Medicare. (Parts A and B)
- 14. PREMIUMS, DEDUCTIBLES, CO-INSURANCE Part B Premium(2014): $104.90 (If your income is above $85,000 (single) or $170,000 (married couple) then your Medicare Part B Premium may be higher) Part B Deductible (2014): $147.00 ( This is an annual deductible. You are responsible for this deductible One Time Per Year) Part B Co-Insurance (2014): Medicare pays for 80%. You will typically be responsible for the remaining 20% of the Medicare approved amount.
- 15. PREMIUMS, DEDUCTIBLES, CO-INSURANCE If your yearly income in 2011 (for what you pay in 2013) or 2012 (for what you pay in 2014) was: You pay (in 2013 and 2014) File individual tax return File joint tax return File married & separate tax return $85,000 or less $170,000 or less $85,000 or less $104.90 above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $146.90 above $107,000 up to $160,000 above $214,000 up to $320,000 Not applicable $209.80 above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 and up to $129,000 $272.70 above $214,000 above $428,000 above $129,000 $335.70
- 17. REVIEW We have just reviewed Medicare: What it is, who is eligible and what it covers. Based on the information we shared, you can see there are gaps in the coverage Medicare provides. You will always be responsible for paying your Premium(s) but there are options available to help relieve you of some of the financial strain you may have due to co-pays, deductibles and co-insurance amounts generally paid out of pocket. Tomorrow we will be discussing these coverage gaps and the options you have to reduce your expenses. You can register for tomorrow’s presentation at: www.MedicareGals.com
- 18. REVIEW If you’d like to speak with a specialist one on one, please call us at: (281) 879-7711 Monday – Friday 9:00 a.m. to 7:00 p.m. On behalf of Trusted Senior Specialists and The Medicare Gals, we would like to thank you for joining us today. We look forward to our next presentation in this series and hope you will join us once again.
- 19. Thank you! We are social! Follow us and become our friend: Facebook.com/TrustedSeniorSpecialists YouTube.com/TSStelevision Pinterest.com/TrustedSeniorSP Instagram.com/TrustedSeniorSpecialists