Medicare is a Federal health insurance program administered by Social Security for Americans age 65 or older and certain younger disabled people. Upon turning 65 most Americans are eligible for Medicare Part A, Part B, Part C (now called Medicare Advantage) and Part D. Medicare Overview - Parts A & B Medicare is composed of two parts; Part A and Part B (know as Original Medicare). Part A is paid for in full from Medicare taxes while working (or a spouses work history), and Part B is partially paid from taxes, but is supplemented with a Part B premium. The 2007 Standard monthly premium for Part B is $93.50. In 2007, Medicare Part B enrollees with higher incomes could pay a higher Part B premium depending upon the extend it exceeds $80,000 ($160,00 for married couples). Upon turning 65, one must enroll in Medicare Part A, but Part B is optional because some people may have other insurance coverage that is primary (certain company group plans or retiree plan). In these cases it is not always necessary or prudent to enroll in Part B. Review your options carefully as there are penalties for not enrolling in Part B when eligible and without other primary coverage.

Important Phone Numbers For Medicare enrollment: contact Social Security at 1-800-772-1213 For Medicare coverage questions: call 1-800-MEDICARE For government sponsored assistance with Medicare and Social Security contact HICAP (Health Insurance Counseling and Advocacy Program) at (800) 434-0222. For information about Medicare Supplemental coverage, contact Phil or John at OnlyHealthInsurance at 1-800-924-1411 or another insurance professional.

Medicare Supplements (also called Medigap) can be purchased to cover the gaps in Medicare Parts A & B. These are standardized benefits that are offered by private insurance companies. Currently there are twelve plans available that companies can offer. They are plans: A, B, C, D, E, F, G, H, I, J, K, & L. Supplements work in conjunction with Medicare. Medicare provides primary coverage and the supplement acts as secondary. A very popular supplement is Plan F because together with Medicare, they will cover 100% of Medicare approved services when seeing any physician/facility that takes Medicare in the country.

Of the different ways to adequately cover one's medical expenses this option provides the greatest freedom and protection available. Please call us for more information about Medicare Supplements. We offer plans from many excellent carriers. And be sure to ask for your free Medicare Guide to Choosing a Medigap Policy.

Part C - Medicare Advantage

Through the Medicare Modernization Act of 2003, Medicare made it easier for private insurance companies to offer alternatives to Original Medicare (Parts A & B) and a Medicare supplemental insurance policy (also known as Medigap policies). Medicare sponsors Medicare Advantage plans as part of the Medicare program and pays the plans to manage beneficiaries' health care. In order to enroll in these plans you will need to have Part A and Part B of Medicare which means paying the Part B premium. You receive all Medicare-covered benefits through the private plan chosen. These plans include:

• Health Maintenance Organizations (HMO)
• Preferred Provider Organizations (PPO)
• Private Fee-for-Service Plans
• Medicare Special Needs Plans
• Medicare Savings Account

These plans can include prescription drug coverage and other extra's such as vision and hearing services and allowances and dental coverage. NOTE: you generally have to see doctors that belong to the plan or go to certain hospitals to get the full value of the plan.

For more information about Medicare Advantage plans available in your area, please contact us.

Part D - Medicare Prescription Drug Program

Part D is a voluntary prescription drug insurance program through Medicare called "Medicare Prescription Drug Coverage" that started January 1, 2006. Medicare created a standard benefit design and asked private insurance companies to market plans that are equal to or better than the standard Medicare design. Click here for a look at the standard benefit design created by Medicare (adjusted for 2007).

This drug coverage is available to everyone who has Medicare, regardless of income or health status. If you have a limited income, you may get extra help to cover prescription drugs for little or no cost. For 2007, in California, there are 23 companies offering 55 different Part D plans. You choose the drug plan and pay a monthly premium. In addition to a premium, you will also have a share of costs determined by the plan you select. Companies have some flexibility on the drugs they choose to cover under their plan (drug formulary) and the pharmacies they contract with but there are some minimum standards. With few exceptions the plans can not change during a coverage year (Jan 1 - Dec. 31). Carriers can change premiums, prescription drug formularies and plan designs for each new plan year, but beneficiaries can also change plans without restrictions on health or pre-existing conditions. This annual open enrollment period (Nov 15 - Dec 31) allows people to change plans to fit new prescription drug needs that offer a better value. In California, plans for 2007 range in cost from $10 - $80. One place to review plans is on Medicare's web site: www.medicare.gov.

Though this is a voluntary program, you may be penalized if you do not enroll when you are first eligible and do not have other coverage that is as good or better than Medicare's standard plan design. The penalty is 1% for every month you were eligible but did not enroll.

Note: it is very important to discuss your particular circumstances with an insurance professional. By enrolling in a Prescription Drug Plan, you may "void" your current coverage. If you are unsure about your eligibility or want assistance in finding an appropriate Part D plan, please call us. We represent several carriers that offer competitive plans and large prescription drug formularies.