Medicare FAQ

Why are preventive services important?

Preventive services can find health problems early when treatment works best and can keep you from getting certain diseases or illnesses. Medicare pays for many preventive services to keep you healthy. Talk with your doctor or health care provider to find out what tests you need and how often you need them to stay healthy.

Medicare premiums and coinsurance rates for 2011

The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2011:

Part A: (Hospital Insurance) Premium


  • Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
  • The Part A premium is $248.00 per month for people having 30-39 quarters of Medicare-covered employment.
  • The Part A premium is $450.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

Most beneficiaries will continue to pay the same $96.40 or $110.50 premium amount in 2011. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium in 2011. For additional details, see our FAQ titled: "Will my Medicare Part B premium increase in 2011?"

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month. For additional details, see our FAQ titled: "2011 Part B Premium Amounts for Persons with Higher Income Levels.

2011 Part B Premium Amounts for Persons with Higher Income Levels

Most Medicare beneficiaries will continue to pay the same $96.40 or $110.50 Part B premium amount in 2011. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less ($170,000 or less for joint filers) will not have an increase in their Part B premium for 2011. For additional details, see our FAQ titled: Will my Medicare Part B premiums increase in 2011?

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month.

Social Security will use the income reported two years ago on your IRS income tax return to determine your premium (if unavailable, SSA will use income from three years ago). For example, the income reported on your 2009 tax return will be used to determine your monthly Part B premium in 2011. If your income has decreased since 2009, you can ask that the income from a more recent tax year be used to determine your premium, but you must meet certain criteria.

Medicare Advantage

Medicare Advantage Plans, also called Medicare Part C (combines A, B and D into an HMO or a PPO with a private insurer) Part C governs the way Medicare benefits are provided by companies that contract with the Medicare program. Someone with Medicare who enrolls in a Medicare Advantage plan generally gets all of their medical services through that plan. Health Maintenance Organizations (HMO's), Preferred Provider Organizations (PPOs) and Private Fees For Service (PFFS) contract with Medicare to provide Medicare benefits in a managed care setting, that since 2006 includes the new Medicare Part D benefit in all but a few HMOs. People enrolling in one of those plans without Part D benefits would need to buy separate coverage for that benefit.

You must pay the Part B premium in order to qualify for a Medicare Advantage Plan.

Please contact our office for more detailed information and assistance.

Medicare Supplement

Medigap: (Also called "supplemental insurance") Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company. A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs.

These Medigap policies can be costly, but useful policies, and can be avoided if you use a Medicare Advantage Plan (above).

Part D: Medicare Prescription Drug Coverage (Stand-Alone Plans with a private insurer) Part D offers some help with prescription drugs. The coverage is voluntary and the monthly premium varies depending on how much coverage you have

Medicare

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