Hassle-Free Health Coverage: How Much Does It Cost?
If you or your spouse worked for at least 10 years in a Medicare covered job (meaning you were having deductions withheld from your paycheck for payroll withholding tax) and you are a citizen or permanent resident of the United States and eligible for Medicare, there is no charge for Part A (Hospital Insurance).
Disabled individuals, kidney dialysis and certain transplant patients are not charged either.
If none of these fit your particular circumstances, you may purchase Medicare Part A if you are at least 65 years of age and meet other restrictions. The per-month cost in 1997 (based on 30 to 40 quarters of Medicare-qualifying employment) was $187. If you worked fewer than 30 quarters during your adult life, the monthly cost was $311.
There is, however, a fee for Part B (Medical Expenses). In 1997, the monthly premium was $43.80 and automatically deducted from Social Security payments. Enrollment is automatic -- unless you state you don't want it -- when you are eligible for premium-free Part A.
If you don't qualify for premium-free Part A, but are 65 or older, you can still buy Part B.
Medicare claims are usually paid on a reimbursement basis, meaning directly to you, the patient -- usually after you've already paid the doctor. Benefit payments may also be made directly to a participating provider. Participating health care providers are certified and approved by Medicare for payment of benefits and have agreed to accept the amount reimbursed by Medicare as payment in full.
This kind of agreement is important, because hospital insurance can help pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care.
For this part of Medicare coverage, you will have to pay a deductible of $760 for each benefit period, beginning with the first day of admission to a hospital and continuing for 60 days. If you are released or hospitalized for more than 60 days, a new benefit period begins and a new deductible applies. That's the bad news. The good news is: There is no limit on the number of benefit periods you can have.
