Medicare, Medicaid and Marketplace are three programs of insurance available to people, and many stress about them. So, I will try to make them easy to understand.
Medicare is a federal program for people older than 65 or those with disabilities. You have three months before and after you turn 65 to sign up.
There are four parts to Medicare A, B, C or Medicare Advantage and D for Drugs.
As a person has worked, they have paid into Medicare A — if they have worked 40 quarters or 10 years, Medicare A is offered to them when they turn 65 at no premium. Medicare A covers hospitalization.Medicare B costs $144.60 a month with a yearly deductible of $203 and covers doctor’s appointments, labs and outpatient surgeries.
Medicare C, or Medicare Advantage, pay $144.60 a month in premium costs that go toward a health insurance company, which in our area is United Health Care. United Health Care becomes your primary insurance, and you do not have traditional Medicare A and B any longer. Many people think we can get all the services that they show on TV in Wyoming, but the simple answer is no.
Along with Medicare A and B, there is also Medicare D for drug coverage. These programs run from $7.30 on up to more than $100 a month. There is a $445 yearly deductible for brand-name drugs with most companies. Open enrollment for Med D is Oct. 15 through Dec. 7.
There is also a program called extra help to pay for Medicare D if you qualify. There are penalties assessed if a person does not sign up for Medicare B and Medicare D when they are eligible.
Medicaid is a 50/50 state and federal matching program that can help those with limited income pay for their Medicare B premium of $144.60 if they qualify. With this program, the top limit is $1,191 for a couple and no more than $3,000 in assets, which does not count your car or home that you live in.
Marketplace Insurance is available to those younger than 65 with income limits of $12,760 a year for one person to $12,2720 a year for a family of five.
The income limits have just changed, so if a person needs insurance and has not qualified for assistance before, there is a special enrollment period now until Aug. 15 to sign up. Call 211 and ask for a navigator or see healthcare.gov to see if you qualify.
I hope this makes the programs listed above easier to understand. If you have questions, you can make an appointment at The Hub on Smith by calling 307-672-2240 for Medicare and Medicaid help or call 211 for more information about the Marketplace.