Medicare In Texas
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What Does Medicare in Texas Cost?
Finding the bottom line cost for Medicare isn't simple. The amount you'll spend can vary depending on the type of coverage you have, your income and assets, and many other factors. But to give you a rough idea, here's an outline of Medicare's costs -- both the obvious and hidden costs.
Medicare Part A:
For most people Medicare Part A is free. That's because they -- or their spouses -- were paying Medicare taxes while they worked.
You might have to pay for Medicare Part A if you were self-employed or didn't work during much when you were younger. If you or your spouse paid Medicare taxes for less than 10 years total, you will have to pay a monthly fee for Part A coverage. In 2009, this Medicare premium is up to $443 per month, depending on your work history.
Medicare Part B:
Part B isn't free. You have to pay a monthly Medicare premium, which is usually taken right out of your Social Security check. In 2009, this fee is $96.40 per month for most people.
If you have higher than average personal income (over $85,000) or household income (over $170,000), you must pay a higher monthly Medicare premium. The exact monthly fee will vary depending on your income, ranging from $134.90 to a maximum of $308.30.
Then, you have to pay a yearly Part B deductible. In 2009, the deductible is $135. After you pay $135 yourself, your benefits kick in.
Part B is optional. If you don't want it -- because you have other coverage through an employer, for instance -- you don't have to pay for it. But you have to ask to opt out. Otherwise, the Medicare premium is subtracted from your Social Security check automatically.
There's a penalty for signing up late. If you don't sign up for Part B when you first become eligible, your monthly Medicare premium may be higher than $96.40.
Medicare Advantage (Part C):
Medicare Advantage are health plans sold by insurance companies, but overseen by Medicare. They are alternatives to Original Medicare, and usually offer more services than Original Medicare, at a higher price.
To qualify for Medicare Advantage, you need to have Medicare Parts A and B. So that means that you'll need to at least pay the Part B monthly fee. For most people, that's $96.40 per month in 2009.
On top of that fee, you may need to pay a monthly premium for the Medicare Advantage plan itself. The prices vary a great deal depending on the plan you've chosen. Some may have further charges, like deductibles and premiums for additional coverage for things like prescription drugs.
Medicare Prescription Drug Plans (Part D):
You must pay a monthly premium and annual deductible to get prescription drug coverage from Medicare. Since there are many different plans, the costs can vary widely.
In most plans, you'll pay:
A monthly premium. The fee varies by plan and region, although the average is $30.36.
A yearly deductible. The standard is $295 in 2009, although it varies depending on your plan. After you have paid the deductible out of your own pocket, your Medicare prescription drug plan kicks in.
Part of the cost of your medications (called a co-pay or co-insurance). Again, the amount depends on the plan you've chosen.
Specific plans differ in their costs, the medicines they cover, and the pharmacies they work with. Some people with low incomes and limited assets will be granted "extra help" to pay for their Medicare drug plan. If you qualify, you may not have to pay the monthly fee and your co-payments will be cheaper when you buy drugs.
There's also a gap in drug coverage -- the so-called doughnut hole. After the total cost of your drugs (what you and your insurer paid combined) reaches a certain level -- typically $2,700 -- Medicare stops paying. You have to start paying your drug costs on your own.
Once the amount you have spent on drugs during the whole year gets high enough -- in 2009 the limit is $4,350 -- Medicare starts paying again. Once this "catastrophic coverage" kicks in, Medicare pays about 95% of all your prescription drug costs for the rest of the year.
Your deductible and all Part D drug co-payments paid that year count toward that $4,350 limit. However, your monthly premiums do not. Keep in mind, many seniors will never need to spend $4,350 because they don't use expensive drugs.
Medigap:
To join a private Medigap plan, you pay a monthly fee to an insurance company in addition to the premium you pay to the government for Medicare Part B.
The costs of Medigap plans vary a lot, depending on the coverage, the company, your location, and your age. Some plans may charge you more if you have any pre-existing health problems. Keep in mind that different companies may charge different rates for the exact same Medigap plan. So make sure to shop around before buying one.
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