Information about medical insurance in Sonoma, CA
How To Apply For Medicare Medical Health Insurance
Medicare is a federal health insurance program that helps U.S. residents who are disabled or who are 65 years of age or older. People who are eligible for Social Security automatically qualify for Medicare hospital insurance (Part A) when they turn 65. Medicare, like other insurance programs, does not pay the entire medical bills. Medicare coverage is divided into four parts identified as Part A, B, C, and D. Original Medicare provides basic coverage for hospitals (Part A) and doctors and outpatient services (Part B). Services are provided through any doctor or hospital that accepts Medicare.Routine expenses not covered by Medicare:
- Dental care, including cleanings, fillings and dentures.
- Long-term care, including custodial care such as daily living assistance for dressing and bathing.
- Vision care such as eye exams, eyeglasses and contact lenses.
- Outpatient prescription drugs unless you have also Medicare Part D coverage.
The gaps in Medicare services may be covered by buying private insurance (Medigap coverage). The coverage of Medigap insurance plans is standardized and regulated by the government.
- Part A (Hospital Insurance)
Includes inpatient care in hospitals, skilled nursing facilities, at home, or in hospices. Blood for transfusions is also covered, except for three pints per calendar year. You must pay co-insurance and deductible charges from your own pocket. A typical 60-day hospitalization would cost you $992 Dollars and the rest would be paid by Medicare. The insurance coverage decreases after 60 days in the hospital, and nothing is paid by Medicare beyond 150 days. For a stay at a skilled nursing facility, Medicare would cover 100% of the approved amount for 20 days. The coverage decreases after that, and nothing is paid beyond 100 days. Items covered:
- Semi-private room and meals
- Regular nursing services
- Anesthesia services
- Operating and recovery room costs
- Intensive care and coronary care
- Drugs, lab tests, and X-rays
- Medical supplies and appliances
- Rehabilitation services (physical therapy)
- Part B (Medical Insurance)
Helps to pay for doctors' services, durable medical equipment, and other medical supplies. Part B also requires co-insurance and deductible payments from your own pocket. In addition, everyone enrolled in Part B must pay a monthly premium which is deducted from your Social Security check or billed quarterly. Medicare pays 80% of the approved amounts for medical expenses, doctor fees, and outpatient hospital expenses. The Medicare Part B monthly premium is based on the income reported on the Tax Return. In 2009, the cost for individuals earning less than $85,001 was $96.40. Higher rates apply to persons with more income. Medicare Part B also has a deductible amount that must be paid before insurance coverage applies. In 2009, you pay the first $135 calendar-year deductible amount and the remaining 20% of the expenses. Items covered:
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