The Truth

The Truth About Medicare!*

Some widely held beliefs about Medicare are misguided or wrong.

 Here, we separate fact from fiction:

Myth: Medicare provides cheap health care.

Fact: It’s true that most people don’t have to pay monthly premiums on Medicare Part A (which covers inpatient stays in hospitals, skilled nursing facilities, hospice and home care. But you will have to meet a deductible before your Part A coverage takes effect.

Myth: Everybody pays the same premium for Part B (which covers doctor visits).

Fact: For the vast majority of Medicare beneficiaries, that’s true (and for them the monthly premium this year has been $104.90).

Myth: Everybody pays the same premium for Part D (which covers prescription drugs.)

Fact: There are 31 Part D prescription drug plans offered for sale in the Houston metropolitan area for consumers that have original Medicare. These Part D drug plans have different costs and coverage associated with each one. It is a good idea to investigate these thoroughly to determine which one is right for you.

Myth: Medicare automatically covers everything.

Fact: Not true, it is a good idea to investigate the coverage you need and what is offered to determine what coverage is best to meet your individual needs.

Myth: You should sign up for Medicare as soon as possible even if you’re working.

Fact: When it comes to Part A, which covers hospitalization, that’s probably a good move. As for Part B, which covers doctors’ visits, the federal government suggests that you wait to sign up, since your at-work insurance is still the primary payer for those medical bills. Visit the Social Security Administration’s website (www.ssa.gov) to sign up, or call the SSA at 1-800-772-1213.

Myth: Medicare covers all hospital stays equally.

Fact: Unfortunately, whether a person is classified as an actual “inpatient” or only “under observation” can make a huge difference in the amount he or she may be responsible for. To qualify for Skilled Nursing Facility care, a person must have been a patient in a hospital for three consecutive days. But if that patient is only in the hospital “for observation,” he or she may be liable for additional charges during the stay – as well as all follow-up skilled nursing facility care. To help prevent this happening, ask the patient’s doctor, and the hospital, to clarify your status.

Myth: When it comes to prescription drug costs, you can’t get help from anywhere but Medicaid.

Fact: Many pharmaceutical companies have Prescription Assistance Programs (PAPs) to help qualified patients pay for medications. Click here https://www.medicare.gov/pharmaceutical-assistance-program/Index.aspx to see what medicines are covered under these programs. You can also check here https://www.medicare.gov/pharmaceutical-assistance-program/state-programs.aspx to see if your state has a Pharmaceutical Assistance Program.