What is covered by Medicare? Ask a lawyer – Orange County Register
Q: I will soon be eligible for Medicare. What are parts A, B and D? Also, I keep hearing about an extra, the letter G.
HD, Torrance
ONE: Medicare is our national health insurance program, started in 1965 and today administered by the Centers for Medicare and Medicaid Services. The abbreviations you mention refer to different types of Medicare coverage. Part A is hospital insurance. This includes hospital inpatient care, a skilled nursing facility, hospice, laboratory tests, surgery, and home health care. Part B covers health insurance, such as physician services, outpatient care, durable medical equipment, home health care, and some preventive services. Part D is a prescription drug plan. Part G is really supplemental coverage, not your primary coverage, but addresses gaps in your Medicare policy. It is not the only supplement to consider.
The bottom line: It is prudent to consult with a knowledgeable Medicare professional, so that you can address your concerns, including about potential premiums. Note that the person you consult may be able to secure coverage from some carriers, but not all. Ask what companies the expert works with and then consider contacting one or more others directly if you want to compare what they can offer and at what cost.
Q: I have Medicare A and B. I was quoted standard rates for B. In “fine print” is language that the amount due each month may not be the actual total based on reported income. mine. After signing up, getting my Medicare B card, and canceling my previous coverage, a letter just came in stating that my premiums are going up quite a bit as a result of my and my wife’s income on our joint profits. we. Can I challenge this?
SR, Long Beach
ONE: Premiums for Medicare Part B coverage may be higher than the “standard rate” if your income is high enough. You are then required to pay an income-related monthly adjustment amount (known as IRMMA). When assessing your Part B premiums, Medicare may obtain information from the IRS showing your revised adjusted gross income (your adjusted gross income plus some non-taxable income). tax). Based on that number, there is a formula where the Part B premium can be higher than the standard rate.
You can apply for a redetermination if you think the calculation is wrong. Additionally, if you have had a life-changing event (such as loss of income or a divorce), you may be able to file or file for redetermination. There is Form SSA-44, which you can find online. Then, if you disagree with the re-determination, there will be a formal appeal process. You can find information about the appeals process on the U.S. Department of Health and Human Services website, hhs.govor by searching for “IRMMA Medicare appeal” in your browser.
Ron Sokol has been a practicing attorney for over 35 years, and has also served multiple times as chief judge, mediator and arbitrator. It is important to note that this column presents a summary of the law and should not be considered legal advice or considered legal advice, let alone a substitute for actual advice with a qualified professional. degree.
https://www.ocregister.com/2022/01/11/what-is-covered-by-medicare-ask-the-lawyer/ What is covered by Medicare? Ask a lawyer – Orange County Register
