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My name is Grant Chapman and I’m a licensed Medicare Supplement and Medicare Advantage Plan insurance broker with CHAPMAN Insurance Group, I specialize in assisting East Tennesseans who are becoming eligible for Medicare to understand the often complicated and confusing healthcare options available during this unique period in their lives.
As your local agent with over 15 years experience, I assist you in designing a plan to fit your needs and budget and help with issues and annual reviews. I'm paid by the insurance carriers, so my service costs you nothing, and you'll pay the same rate whether you go direct or work with a local agent, so let me do the work for you!
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You have options for supplementing your Medicare, there's Medicare Advantage plans, Medicare Supplements, employer group retirement benefits, Tri-Care, the VA and not to mention the Part D drug plans, and maybe a continuation of coverage through a past employer.
I have a no non-sense approach to giving you the information you need to make an informed decision about Medicare Advantage Plans, Medicare Supplement Plans, and Part D drug plans. I am an unbiased resource, I work with all the major Medicare Insurance carriers and my service costs you nothing.
Original Medicare is broken down into two parts, Medicare Part A (hospital) and Medicare Part B (outpatient). There is no additional cost for Part A, Part B for most folks will have a cost of $134.00 (for people who sign up beginning 2017)
MEDICARE PART A
When you are admitted to the hospital Medicare Part A is activated and there is a deductible that is due, for 2017 is $1316.00*. This is good for a 60 benefit period. Under Medicare Part A the window of time for the Medicare Part A deductible is 60 days, meaning if you are admitted, then discharged, and readmitted to the hospital in that same 60 days, then the one deductible applies for Medicare Part A, however if you are admitted back into the hospital after the original 60 days, then a new Medicare Part A deductible applies. Also if you are in a continuous hospital stay longer than 60 days, beginning day 61 thru day 90 there is a daily co-pay up to $329.00 per day. If you are longer than 90 days, beginning day 91 thru day 150, there is a up to $658 daily co-pay...in the last 60 days, which Medicare calls "lifetime reserve" days Medicare will run out and you would be responsible for all the costs after the 150 days of continuous hospitalization. Next comes skilled nursing, in a skilled nursing facility, Medicare pays for the first 20 days, after that from days 21 thru 100 there is a $161.00 daily co-pay.
MEDICARE PART B
Medicare Part B works much like your traditional major medical health insurance does, after the annual deductible for 2016 is $183.00* then it's 80% Medicare pays and 20% you pay. With one rule (according to Medicare assignment) meaning Medicare and your doctor agree on the cost. Your doctor can charge up to 15% over what Medicare allows, this is referred to as an "Excess Charge".
It is important to add there are no Maximum Out Of Pockets on Original Medicare! That's why most people will protect themselves with some sort of supplemental plan whether it be a Medicare Supplement or Medicare Advantage Plan.
*updated from CMS as of 12/26/2016