First the basics. What is Medicare? What are Parts A, B and C, and why should you be interested in learning more about Medicare? Primarily because it will affect your life in some way, shape or form.

   Medicare is universal health insurance for groups of individuals that include the aged, blind and disabled. It is universal in the sense that all those 65 and over are covered by it if they or their spouse paid into the Social Security System for at least 10 years. It also covers those under 65 if they have been determined to be eligible through medical examinations. Another factor that makes Medicare universal is that those 65 and older cannot go into the commercial insurance market and purchase health insurance independently.  It is not a means tested program. Eligibility is not based on income. 

   Medicaid is health insurance that is means tested and some seniors are dually eligible for Medicare and Medicaid. Even though elders cannot purchase primary insurance coverage after 65 they can purchase what is called Medigap insurance to cover the deductibles and co-payments that exist for Medicare beneficiaries. Medigap policies are offered by commercial insurers and come in a variety of forms and benefit choices. Medicare Part A covers hospital charges and does not involve a premium. Part B covers doctor visits and other outpatient costs. It is optional and there is a premium payment associated with it.  Part C is what is known as Medicare Advantage and incorporates Parts A, B and D. Medicare Advantage is based on a health maintenance organization (HMO) model. Medicare and Medicaid were enacted into law in 1965 under President Lyndon Johnson and have been in a process of continuous evolution ever since. The programs are administered by the Centers for Medicare and Medicaid Services (CMS) which is the largest insurance company in the world.

   Now to Medicare Part D:  it became law in 2003 under President George W. Bush.  It is the first drug benefit to be available for Medicare beneficiaries.  Between now and December 31^st, people need to review their Part D coverage and make sure they are getting the best plan possible for their needs.  Regardless of your political leanings, most people agree that it is a deeply flawed program THAT IS VERY CONFUSING. This part of Medicare is also optional and requires payment of  a premium. Then there is the famous “donut hole” which is a gap in coverage between specific dollar amounts. People in the donut hole pay out of pocket until they reach the required dollar amount for “catastrophic” coverage to kick in again. That's why I have timed this edition of the newsletter to coincide with my interview of Cindy Loftin with LIFE Senior Services who manages the Senior Health Insurance Counseling program. Listen to our interview at Women's Radio to learn more and please feel free to send me your questions. If I don't know the answer, Cindy will.

Cindy Loftin