MEET & GREET With Jill
Jill Clifford , Managing Agent
Join Jill at one of her local upcoming events!
Jill Will Be Covering:
* "ABCD's of Medicare" * Free Educational event on the basics of Medicare and your choices for coverage
* No cost nor obligation
MEET & GREET
Attend One Of Jill's Local Workshops and Receive Updates and Announcements 100% FREE!
September 26, 2024
10 am - noon
Auburn Annual Health Fair
Auburn Senior Center Gym 808 9th St SE, Auburn, WA 98002
October 5, 2024
1 pm - 2:30 PM
Auburn Public Library
1102 Auburn Way S,
Auburn, WA 98002
October 24, 2024
11 am - 2:00 PM
Health & Wellness Fair
25035 104th Ave SEKent, WA 98030
Sponsored By:Cogir of Kent, Senior Living
Articles Quick Access
The ABCD’s of Medicare – Basics of Medicare by Jill Clifford
Medicare is a complex set of laws signed on July 30, 1965, by President Lyndon B. Johnson, providing insurance coverage for people over sixty-five, those under sixty-five with certain disabilities, people with Amyotrophic Lateral Sclerosis (Lou Gerhrig disease), and anyone with end-stage renal disease. I am going to walk you through the history of this complexity step by step. In the next article, I’ll discuss more details on available coverage, enrollment options and requirements, premiums and penalties, and additional programs like Medicaid and Extra Help.
Original Medicare provided only Part A (hospitalization, skilled nursing facilities, & blood) and Part B (doctor services, outpatient hospital service, plus most other medical services that Part A does not cover). The Omnibus Reconciliation Act of 1980 expanded home health services and brought Medigap (Medicare supplement insurance), under federal oversight. In 1982, hospice was added to Part A.
In 2003, the Medicare Modernization Act (MMA-2003) signed by President George W. Bush, added Part C, which allowed private insurance companies to offer Medicare Advantage plans, if approved by CMS (Center for Medicare and Medicaid Services), that combined Parts A and B, and added prescription drug coverage for most plans. The MMA-2003 also specified that as of January 1, 2006, all Medicare recipients were required to have credible prescription drug coverage, then named Part D.
Therefore, as of 2006, all Medicare recipients are required to have Medicare Parts A, B, and D, or credible insurance and prescription drug coverage as good as the standard Medicare plan. Note that prescription drug discount or medical discount plans are not considered credible coverage. Credible insurance can be employer insurance plans, Veteran coverage like Tricare or VA benefits, or government or private pension plan insurance, or a Part C Medicare Advantage plan. Tricare for Life and ChampVA also require enrollment in Part B. Note that COBRA is not considered credible coverage. Also note that MMA-2003 specifies penalties for not enrolling in Part B or Part D when eligible, unless the individual has other credible coverage.
The “Your Medicare Coverage Choices” diagram displays our current choices for Medicare coverage. If we have other credible medical and prescription drug coverage, we may only have Medicare Part A. Otherwise:
1. We can have original Medicare Parts A and B, to which we add a Part D plan (unless we have other credible prescription drug coverage).
2. We can have original Medicare Parts A and B, plus Part D (unless we have other credible prescription drug coverage) and add a Medigap policy.
3. We can have a Medicare Advantage plan (MAPD) with Part D included.
4. If we have other credible prescription drug coverage, we can have a Medicare Advantage plan (MA) without prescription drug coverage. Those without prescription drug coverage are often called “veteran plans,” as the people who enroll in them are most often veterans who get their prescriptions from the Veterans Administration.
Diagram Reference: Centers for Medicare and Medicaid Services, September 2016, Medicare and You: The official U.S. government Medicare handbook, U.S. Department of Health and Human Services.
