Page 39 - May 2020 Web.indd

Medicare Part “B”, referred to as “Medical” on your red, white,
and blue card, covers 80% of outpatient care, all healthcare ADULT CARE
provided outside of an admitted hospital stay, including Mid-Shore Residential Care
doctors’ visits, medically necessary blood work, x-rays, MRIs,
preventative services, and durable medical equipment. Th e
Compassionate Care in Your Home for 24 Years
premium for “B” in 2020 is $144.60 per month and is generally
CNA’s • Sitters • Home Health Aids • Meal Preparation
deducted automatically from your social security check. If
RN Evaluations • Residential Cleaning

you are not yet collecting Social Security benefits you will
be directly billed on a quarterly basis for $433.80. (NOTE: If Lic.#R922 INDIVIDUAL SERVICES
you have not signed up for “B” due to employer coverage and www.midshorehomecare.com 410-820-1131
that employment ends, you have eight months to sign up for
long as you pay the premium monthly, your only out of pocket

“B” without incurring a significant penalty. To sign up for “B”
costs with the Medi-Gap G insurance is the annual deductible;
while you are employed, or during that eight months aft er
everything else is covered! The right supplemental insurance

employment ends, you must fill out form 40-B.) Call me for
policy can be the difference between bankruptcy and fi nancial

more information.
piece of mind when you have health issues.
Moving right along, “B” has an annual deductible which has
To sum up... A = Hospital, B = Medical Outpatient plus
been going up each year. This year it is $199 out of your pocket

Supplemental (GAP insurance) to cover A & B copays,
before Medicare pays anything plus you are responsible for
coinsurances and that repeating A hospital deductible. Th ese

the 20% not covered by part “B”. That 20% is reason #3 to buy
are the facets needed for complete medical coverage under
supplemental insurance.
Medicare. “D” Prescription Drug coverage will be addressed
Since part “B” only covers 80% of one’s outpatient costs, and after an intro to “C”.

“A” has mind boggling deductibles and co-payments, SHIP
Medicare “C” is Advantage. This is not Federally funded
strongly urges all Medicare recipients in Original Medicare to
Original Medicare. It is the form of Medicare which is
purchase supplemental insurance from a reputable insurance
sub-contracted out by the Federal Government to individual
agent who specializes in Medicare Supplemental insurance.
companies and Hospital systems who act as both Medicare
Take advantage of the Guaranteed Issue period of six months

Insurance and Health Care Providers. Therefore, since they are
surrounding your 65th birthday to apply for this insurance
acting in the place of Medicare, they can refer to themselves
without going through medical underwriting. Technically

as Medicare Advantage when advertising. These are the big
it’s seven months; that is three months before, the month
TV advertisers during open enrollment who off er “expanded”
of, and the three months following your 65th birthday. Do
Medicare services which are actually not covered by Original
not wait until you have been hospitalized or develop health
Medicare. Needless to say, this confuses a lot of folks who think
problems. Waiting past this period will, at best, increase your

the advertisers are offering products to all Medicare recipients.
premium due to health issues and, at worst, allow the insurance
companies the right to refuse you coverage. Federally funded Medicare oversight is provided by CMS,
(the Center for Medicaid and Medicare) and CMS requires
Supplemental plans are also known as Medi-Gap plans. Th ese
Advantage plans to offer more coverage than Original Medicare

supplemental plans are standardized by the federal government
… those required perks are what they are advertising! In 2020
to ensure that the coverage of a given plan is the same no
some of the additional coverages supplied by Advantage are
matter where you are in the USA. If a service is covered by
$800 annually toward dental services, up to $150 allowance
Original Medicare, it is by law covered by the supplemental
per year toward routine vision services, and $1,350 every three
plan! Medi-Gap plans are not required but are essential.
years for hearing services. It would be nice if Original Medicare

Beneficiaries purchase these plans to cover all the Medicare Part
Beneficiaries were able to take advantage (pun intended!) of

“A” deductibles, coinsurances, and hospital costs outlined above
these necessities, huh?!? Talk to your elected offi cials about
plus part “B” 20% co-pays. Please note that any supplemental
expanding Original Medicare coverage!
insurance policy you buy will not pay any Part “B” penalties
assessed for late enrollment since the penalty is considered part “C” plans only work within specific geographical territories,

of your “B” premium and is not a medical expense. such as the territory of Queen Anne, Talbot, Caroline and Kent

counties. Advantage “C” plans offer services strictly within
It can be confusing when comparing supplemental plans
their own network of doctors and hospitals. If one leaves that
simply because the powers that be decided to name the plans

territory or network, the beneficiary is not insured and does
alphabetically…just like the three mandatory parts of Medicare
not have medical coverage at all, except for limited immediate
(“A”, “B,” D”)! To give you an idea of how these plans function,
emergencies. This means all costs for hospitalizations,
let’s examine a G. The G supplemental insurance policy covers

non-emergency procedures, and doctors’ visits are the
all hospital part “A” deductibles and copays, plus all the 20 %

beneficiary’s responsibility when out of network. Th erefore,
outpatient “B” costs, Except for the annual “B” deductible. To
Advantage functions best in highly populated areas, such as
reiterate, the “G” supplemental policy does not pay the one
Baltimore. The great thing about Original Medicare is that you

time per year part “B” deductible, which in 2020 is $199. As
39