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When you reach that golden age, or perhaps are helping a parent make these choices, it’s good to know some of the rules and time frame of Medicare options. Medicare is a federal health insurance program that covers people age 65 and older. There are two parts, A and B, and most people who have worked or whose spouse worked and paid Medicare taxes, automatically qualify for Part A. Part A covers inpatient hospital care, critical care, limited skilled nursing facility stays, hospice care and some home health care. There is no premium for Part A. Part B covers outpatient hospital services, doctor’s care, physical and occupational therapy, and home health that is not covered under Part A. There is a premium for Part B, which in 2004 is $66.60 per month.

If the 65 year old is still working and has coverage through their employer, they may waive their Medicare Part B option and continue their group insurance. The key here is to formally “waive” their Part B rights, so that the “open 6 month enrollment” is not lost when they cease working. W hen the over 65 year old does want the Medicare Part B coverage, either at their birthday or ceasing employer group coverage, and has applied and been notified by Social Security that they have Part B coverage, the person has a 6 month open enrollment period for supplemental Medicare coverage at guarantee issue. This means one is eligible for supplemental coverage through a Blue Cross, Medica, or HealthPartners’, without proving insurability (passing health history). If one applies after they have had Part B Medicare for 6 months, or did not formally waive at an earlier time, supplemental coverage could be denied due to health history. There is however, an annual open enrollment period.

Finally, regarding the federal Medicare approved Drug Discount Cards, which advertise discounts of 10-25%, and cost around $30 a year, be advised that many of the supplement plans already have access to similar drug discounts, without the added cost. Members who have not purchased an extra drug rider automatically have access to a “Medica’s Rx Savings Program" or “Blue Cross’ Rx Advantage”, and therefore would already have access to these discounts. Always feel free to call me with questions or concerns…

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