I called an expert and this is what I learned: The basics are broken down into four categories. Part A covers hospital services. If you paid into Social Security through your working career, were in a government job or teaching, this plan is usually free and covers 80 percent of the approved Medicare amount of inpatient services such as hospital and rehabilitation home stays.
Part B covers outpatient services such as doctor visits plus physical and occupational therapy requiring no overnight stays. Part B costs $104.90 per month (the new rate as of Jan. 1) and is deducted from your Social Security check. That covers 80 percent of the approved Medicare costs.
Part C includes Medicare Advantage plans. This is a follow-the-bouncing-ball story, so I’ll try to keep it simple. In Plan C, you can assign your Medicare benefits to someone such as Kaiser, SCAN or Secure Horizon, which becomes your Medicare provider. Your Medicare payment of $104.90 is still taken out of your Social Security, but an additional payment is assessed to cover other benefits. These plans can be purchased through an agent or online. Your Advantage plan puts you in the driver’s seat – you can choose your medical group and/or doctor.
Part C works like an HMO in the sense that your primary-care physician refers you to specialists. Now here comes another bouncing-ball detail: In order to enroll for Part C, you must belong to A and B.
The newest Medicare category, Part D, covers your medicines. It can be used in conjunction with Part C – as log as you belong to A and B.
Leah McIntosh, who has been working for HICAP (Health Insurance Counseling and Advocacy Program) since 1999, is my source of information. HICAP is a volunteer-based Medicare counseling program that (in addition to many other services to seniors) conducts a 2½-hour presentation that explores the basics of Medicare and related coverage.
You needn’t be 65 to participate in Leah’s classes. If you’re responsible for a senior or simply wish to educate yourself on the ins and outs of the Medicare system, this is perfect for you … and apparently me!
The free program is offered usually on the third Wednesday of the month from 2-4:30 p.m. at the Liberty Adult Education Center, 929 Second St. Classes are free of charge but preregister is required. Call 925-634-2565. A minimum of eight must attend for Leah to hold the class. More program information can be found by calling 800-510-2020 or visiting www.cchicap.org.
I plan on attending one of Leah’s classes, not only to learn more about how I can help my mom but to be prepared for myself. I’m not that far applying for Medicare, and Leah makes something that sounds like alphabet soup understandable as well as interesting – and even fun.
Marla Luckhardt is a Discovery Bay resident and member of the East Contra Costa Senior Coalition. She works with several local senior care and advocacy groups. To contact her, e-mail firstname.lastname@example.org.