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Join us at noon CT on Tuesday, December 7, to chat about Medicare.

The first baby boomers turn 65 next year. What do they need to know about Medicare, the government's vast healthcare program for people 65 years and older? How is this program structured and what benefits does it provide? How do people enroll? What medical expenses are and are not covered by Medicare? How is health reform changing the outlook for people on Medicare? What are Medicare Advantage plans and how are they changing? Our experts from the Medicare Rights Center can answer these questions and more.

Experts: Medicare Rights Center in New York City: Doug Goggin-Callahan, client services and program counsel; Hannah Oakland, health advocacy professional services associate; Nathan Heggem, policy and communications associate; Akiko Takano, deputy director of communications; Susan Batkin, director of hotline operations and volunteer management

Moderator: Judy Graham, Chicago Tribune

Can't make the chat? E-mail questions in advance to jegraham@tribune.com

Health Chat: Medicare

(12/07/2010)

  

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11:51

Judy Graham:  Thanks for joining us for this chat on Medicare, the government’s health program for people 65 and older and people with serious disabilities. The Baby Boomers will come to know this program intimately as they begin to turn 65 next year and start enrolling. We hope our conversation here will give you an introduction to the basics of Medicare: the benefits the program covers, how it works, some information about costs. What we won't be able to do today is give advice to individuals who are having issues with Medicare. If you want to go over the specifics of your situation, contact the Medicare Rights Center -- the experts who are with us today -- at 1-800-333-4114. Also, we're not going to get into a political debate here over the future of Medicare. That's an important subject, but not the goal of this chat. The Medicare Rights Center is a national group that helps people with Medicare coverage. They're based in New York City and we are happy to have them with us today. Our chat will begin in a few minutes. Hang on. Tuesday December 7, 2010 11:51 Judy Graham

12:00

Judy Graham:  Why don't I begin? Can you tell me who qualifies for Medicare? Do you have to be 65? Tuesday December 7, 2010 12:00 Judy Graham

12:00

Akiko Takano:  No, you don't have to be 65 to have Medicare. People who are under 65 who are disabled and who have been receiving Social Security Disability Insurance for two years are also eligible for Medicare. So are people who have been diagnosed with End-Stage Renal Disease or Lou Gehrig's Disease. You can get more information here: http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=15 Tuesday December 7, 2010 12:00 Akiko Takano

12:00

Judy Graham:  Can everyone 65 and over get Medicare coverage? Tuesday December 7, 2010 12:00 Judy Graham

12:01

Akiko Takano:  No. You can get Medicare when you turn 65 if you are a U.S. citizen. Or if you have a green card AND have lived continuously in the United States for at least five years before the month you enroll. Tuesday December 7, 2010 12:01 Akiko Takano

12:01

Judy Graham:  Is there a requirement that you have worked for a certain period of time? Tuesday December 7, 2010 12:01 Judy Graham

12:02

Chicago Tribune:  To our readers online: You can participate in this Q&A, too. Just type your questions in the white box below and hit the green send button. Then our panelists will be able to see it and respond, too! Tuesday December 7, 2010 12:02 Chicago Tribune

12:02

Chicago Tribune:  Back to the answer to Judy's question... Tuesday December 7, 2010 12:02 Chicago Tribune

12:03

Doug Goggin-Callahan:  Kind of. Part A is free if you've worked and paid your Social Security taxes for at least 10 years. If you haven't, you can still get Part A by paying a premium. Tuesday December 7, 2010 12:03 Doug Goggin-Callahan

12:04

[Comment From Sarah VSarah V: ]  How do you actually sign up and when do you have to? Tuesday December 7, 2010 12:04 Sarah V

12:04

Hannah Oakland:  Enrollment into Medicare is done by the Social Security Administration, which can be confusing because the benefit itself is administered by Health and Human Services. The enrollment process looks very different for people who have End Stage Renal Disease; if you have questions about that, you should contact the Medicare Rights Center or 1-800-Medicare. When you become eligible for Medicare, enrollment happens in one of a few ways. You are automatically enrolled into Medicare if you are receiving any form of monthly check from the Social Security Administration. For example, if you begin to receive your Social Security retirement check before you turn 65, you will be enrolled into Medicare Parts A and B for the first of the month when you turn 65. Part A is free for most people, but you have the option, as always, to decline Part B. This rule also applies for people who are under 65 and become eligible for Medicare because they have received 24 months of Social Security Disability checks. All of these people are automatically enrolled into Medicare Parts A and B the first of their 25th month of receipt of SSDI. If you are not enrolled into Medicare automatically because you are waiting for your full retirement age to begin collecting Social Security retirement, for example, you will not be automatically enrolled into Medicare. You must call the Social Security Administration to enroll. Tuesday December 7, 2010 12:04 Hannah Oakland

12:05

Susan Batkin:  When you become eligible for Medicare by way of disability, you will automatically be enrolled into Medicare after 25 months. You will receive your medicare card in the mail. Tuesday December 7, 2010 12:05 Susan Batkin

12:05

[Comment From SamuelSamuel: ]  What is the difference between Medicare part A, B and D? Tuesday December 7, 2010 12:05 Samuel

12:05

Akiko Takano:  Medicare is a huge program, and it's divided into several parts. Each part covers a specific set of benefits, and has different costs. Part A covers most of the care you receive at a hospital or nursing home. It also covers hospice care and, under certain circumstances, home health care. Part B is medical insurance, and covers doctor's visits, many preventive services, medical equipment such as wheelchairs, lab tests, services you receive at clinics based in hospitals, and mental health care. Part D covers prescription drugs. Tuesday December 7, 2010 12:05 Akiko Takano

12:06

[Comment From Bruce HBruce H: ]  What is the doughnut hole for the prescription drug benefit? Tuesday December 7, 2010 12:06 Bruce H

12:06

Susan Batkin:  When you become eligible for Medicare by way of age, you have a seven month window -- referred to as your initial enrollment period -- to enroll into Medicare. This is the three months prior to your 65th birthday, the month of your 65th birthday and the 3 months after your 65th birthday. Go to your local social security office to enroll. If you receive social secruity retirement, you will automatically be enrolled into Medicare. Tuesday December 7, 2010 12:06 Susan Batkin

12:07

Judy Graham:  This is Sue's answer to an earlier question about when to enroll in Medicare. Hold on for the answer to the question about the doughnut hole. Tuesday December 7, 2010 12:07 Judy Graham

12:08

Nathan Heggem:  This is the answer to the doughnut hole question: The coverage gap is unique to Medicare prescription drug coverage (Part D). If you have Part D, at some point during the year the amount you pay for your prescriptions may suddenly increase dramatically. This may be because you have reached the coverage gap (sometimes called the “doughnut hole” or "second deductible"). The coverage gap is just what it sounds like: while you're in the gap you get no coverage at all and have to pay the full cost of your prescriptions. The gap starts when the total cost of your prescriptions—what you and your plan have paid for covered drugs -- reaches a certain amount ($2,830 in 2010 and $2,840 in 2011). You still have to pay your drug plan's monthly premium while you are in the gap. In 2010, in all plans, the coverage gap ends when your total out-of-pocket costs for covered drugs (just what you have paid) reach $4,550. After that you'll have "catastrophic coverage" and will pay 5 percent of the cost of each covered drug, or a copay of $2.50 for generics and $6.30 for brand-name drugs, whichever is greater. But things will change for the better next year, thanks to health reform. In 2011, you will receive a 50% discount on brand-name drugs while in the gap and a 7% discount on generic drugs. The good thing is, both what you pay out of your own pocket AND the 50% brand-name discount will be included in the calculations that determine when you've reached the end of the gap. So if you fall into the doughnut hole next year, you'll pay less and get out more quickly. Tuesday December 7, 2010 12:08 Nathan Heggem

12:09

[Comment From RickeyRickey: ]  how do you figure a late penalty? Tuesday December 7, 2010 12:09 Rickey

12:10

Judy Graham:  Questions are coming in thick and fast. Hold on as we prepare answers. Tuesday December 7, 2010 12:10 Judy Graham

12:10

Hannah Oakland:  Great question. Generally, you will not get a late enrollment penalty on Part A. However, you will begin to get a penalty for Part B if you decline it and do not have insurance from you or your spouse's current employer. This penalty is 10% for every 12 months when you do not have Part B or current employer insurance. Part D has a different penalty. You can generally decline Part D if you have "creditable" coverage, or coverage that is as good or better than Medicare Part D. If you do not have Part D or creditable coverage, you accrue a 1% penalty per month. Tuesday December 7, 2010 12:10 Hannah Oakland

12:11

[Comment From CarolynCarolyn: ]  How do you determine if you should enroll in a Medicare Advantage Plan or get a Medicare Supplement? Tuesday December 7, 2010 12:11 Carolyn

12:11

Susan Batkin:  The answer to this depends on your preferences and your health care needs. If you enroll in a Medicare Advantage plan you will get your care through a private plan. You will have to comply with the rules of the plans. For example, you will need to go to the doctors that are in the plan's network. Another option is to enroll into Original Medicare. This allows you to get your coverage through the government and go to any doctor that accepts Medicare. However, you will have a 20% co-insurance for most services so a supplemental policy may be necessary to cover your costs. If you have the in come to pay for a supplemental plan, this may provide you with the greatest number of options. Tuesday December 7, 2010 12:11 Susan Batkin

12:11

[Comment From Bruce HBruce H: ]  What are the options for medicare supplement coverage and what is a medicare advantage? Tuesday December 7, 2010 12:11 Bruce H

12:12

Doug Goggin-Callahan:  Medicare Advantage is another name for the Medicare benefit administered through private insurance plans. Medicare Advantage plans have to offer the same benefits as Medicare from the federal government and they can also offer more benefits -- of course you have to remember that like most health insurance plans you'll have a network in a Medicare Advantage plan. Medicare supplemental policies are sometimes called Medigaps. They are designed to fill gaps in Original Medicare, and they typically cover deductibles, coinsurances, and some additional benefits. You can't have a Medigap if you have a Medicare Advantage plan. There are different kinds of Medigap plans, and they are standardized by letter. They are lettered A-N and the benefits are different depending on the letter. As a general rule of thumb the lower letters offer fewer benefits and cost less. Each letter offers the exact same benefits no matter which company sells you the plan. So, for example, if you're looking to buy Plan F, you'll find that the benefits are the same no matter what insurance company you buy Plan F from. Here is a link to a chart that shows what is covered by each type of Medigap plan: http://www.medicarerights.org/pdf/june2010medigaps.pdf Cost and availability of Medigap plans vary widely by state, and some states have their own set of standardized plans. It's best to call your State Health Insurance Assistance Program (SHIP) to learn more about Medigaps in your state. Go to www.shiptalk.org to find the number for your state's SHIP. Tuesday December 7, 2010 12:12 Doug Goggin-Callahan

12:12

[Comment From DianeDiane: ]  Can you also enroll in Medicare online? Tuesday December 7, 2010 12:12 Diane

12:13

Hannah Oakland:  Actually, yes! The Social Security Administration just created a way for most people to enroll in Medicare online. You can do so here: http://ssa.gov/medicareonly/ Tuesday December 7, 2010 12:13 Hannah Oakland

12:14

Judy Graham:  You refer to "original Medicare" above. Can you explain what that is? Tuesday December 7, 2010 12:14 Judy Graham

12:15

Nathan Heggem:  Original Medicare is the traditional Medicare program offered directly through the federal government. Under Original Medicare, the government pays directly for the health care services you receive. You can see any doctor that takes Medicare (and most do) anywhere in the country. Original Medicare is sometimes called "traditional" Medicare. Unless you make another choice, you will have Original Medicare. You can also choose to get your Medicare benefits from a Medicare private health plan. Tuesday December 7, 2010 12:15 Nathan Heggem

12:16

[Comment From SusanSusan: ]  I was told I needed to enroll in a drug plan, but I don't take very many medications. Should I just pick a plan with a low premium? Tuesday December 7, 2010 12:16 Susan

12:16

Susan Batkin:  THere are many things to take into consideration when selecting a drug plan. One consideration is the premium. Another consideration is whether the drugs have restrictions -- prior authorization, step therapy or quantity limit restrictions. If you don't take many drugs, then premium would be a large consideration. Call Medicare to find out restrictions on drugs. THis could be a big factor in your decision. Tuesday December 7, 2010 12:16 Susan Batkin

12:18

[Comment From Bruce HBruce H: ]  What are the out of pocket costs for the various parts of Medicare? Tuesday December 7, 2010 12:18 Bruce H

12:18

Doug Goggin-Callahan:  As noted above, for people who have 10 or more years of work history, Medicare Part A -- hospital insurance is premium free. Medicare Part B --- outpatient insurance has a monthly premium. In 2011 that premium will be $115.40. For most Medicare Part B services the co-insurance (i.e. the amount you pay) is 20% of the cost of the service. There are also certain deductibles you must meet before coverage begins. For Medicare Part A the deductible is about $1,100. Medigaps can help with some of these costs although you will need to pay the Medigap monthly premium. Medicare Advantage plan costs vary -- though you can find out about the plan specifics in the explanation of coverage (EOC) for each plan. Those are often available online. Tuesday December 7, 2010 12:18 Doug Goggin-Callahan

12:19

Judy Graham:  I understand you have some resources for consumers that help people choose a Medicare drug plan. Tell us where to find them. Tuesday December 7, 2010 12:19 Judy Graham

12:20

Akiko Takano:  Yes, we do. For more questions that you should consider when selecting a drug plan, please go here: http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=1204 Tuesday December 7, 2010 12:20 Akiko Takano

12:20

[Comment From DianneDianne: ]  I am currently employed and have medical insurance coverage through my employer. I am eligible for Medicare, but plan to work a few more years. When I decide to enroll in Medicare and a Prescription Drug Plan, what will determine the cost of my Medicare Premium and PDP? Tuesday December 7, 2010 12:20 Dianne

12:20

Hannah Oakland:  As long as you have coverage from an employer for whom you are currently employed, you should not be incurring any penalties for Medicare Part B if you choose to decline it until you retire. When you retire and sign up for Medicare Part B, the premium will be the standard Part B premium for each year, which changes annually. In 2010, it is $110.50 and in 2011, it will be $115.40. If your income is high, you may have to pay a higher, adjusted Part B premium. As for your prescription drug plan (PDP), you will not incur any penalties for waiting to enroll as long as you have "creditable" coverage, or coverage as good or better than Medicare's. Ask your employer if your prescription drug coverage is creditable. When you enroll into Part D, there will be a variety of plans available to you. In 2011, the premiums generally range from $20 to $100 per month. Tuesday December 7, 2010 12:20 Hannah Oakland

12:22

Judy Graham:  Wow. There's a lot of interest in this topic. That's not surprising. Hold on as we work on answers to more of your questions. Tuesday December 7, 2010 12:22 Judy Graham

12:23

[Comment From Carol MonroeCarol Monroe: ]  I am in an HMO. Folks tell me I don't need to apply for Medicare as I am covered by the HMO. If so, is it wise to wait until I'm 66 to apply for Medicare? Are their any penalities. I will be 65 in 2012. Tuesday December 7, 2010 12:23 Carol Monroe

12:23

[Comment From Carol MonroeCarol Monroe: ]  I will be 65 next and will continue working until 2012 as I will be 66. Tuesday December 7, 2010 12:23 Carol Monroe

12:24

Susan Batkin:  if you are 66 and have health coverage based on current employment, you may be able to wait to enroll in Medicare. The operative word here is CURRENT employment. If your company has fewer than 20 employees, then you must enroll in Medicare or risk a penalty later. If your company has greater than 20 employees, then your employer coverage is primary and you can wait to enroll in Medicare without penalty. Check with your HR department for more comprehensive information. Tuesday December 7, 2010 12:24 Susan Batkin

12:24

[Comment From TomTom: ]  My father currently is in the hospital. He opted out of Medicare 8 years ago at the age of 71. He has his own insurance. What steps do I need to take to get him back into the medicare program? Also can he use his current insurance as his supplemental insurance? Lastly, what impact will it have on his current insurance coverage since he is in the hospital? Tuesday December 7, 2010 12:24 Tom

12:24

Judy Graham:  This is a complicated set of questions. We're going to take a crack at the first. Tuesday December 7, 2010 12:24 Judy Graham

12:25

Doug Goggin-Callahan:  As Hannah noted above -- in general -- the only individuals with current employer insurance can opt out of Medicare without facing a premium penalty. If your father wishes to re-enroll into Medicare he must wait until the general enrollment period, which runs from January through March. Medicare coverage will begin in July of that year. So if for example, he re-enrolls into Medicare in January of 2011, his coverage will begin in July 2011. He will however have a late enrollment penalty. Whether Medicare is primary or secondary will depend on the type of insurance your father currently has, however, for most people over the age of 65 Medicare will be the primary payer. Tuesday December 7, 2010 12:25 Doug Goggin-Callahan

12:27

[Comment From ChuckChuck: ]  I heard on the news recently that a lot of doctors aren't taking on new medicare patients because of the cost and reimbursements. Is there any truth to this or just a scare tactic? Tuesday December 7, 2010 12:27 Chuck

12:28

Akiko Takano:  That is a good question, and yes, this issue has been in the news. The Medicare Payment Advisory Commission recently published a report, an annual survey, that found that people with Medicare are actually having less trouble finding a doctor and also having less trouble getting appointments than people who are 50-64 and are have private health insurance. Tuesday December 7, 2010 12:28 Akiko Takano

12:28

[Comment From Vicki AsburyVicki Asbury: ]  I want to warn people on soc sec disability that if you decline to enroll into part B because you have coverage via your spouse, that private coverage must end when your spouse is laid of or retires early. Our company told us I could still be on the company health plan, so we stayed on it. Then when we had a hospital bill, the group insurance did not pay because I should have been in medicare B I paid the private insurance premiums for 3 years. Now I dont have coverage because medicare B wont let me enroll. Tuesday December 7, 2010 12:28 Vicki Asbury

12:28

Hannah Oakland:  That is an excellent point and I'm sorry to hear about your situation. A lot of people run into this problem because they (or their employers!) are not aware of the extraordinarily complicated rules about enrolling into Medicare. To reiterate Ms. Asbury's point, you are generally only allowed to wait to enroll in Medicare if you have current employer insurance, which does not include retiree insurance or COBRA. You will probably have to wait until January of 2011 to enroll into Medicare Part B which will begin July of 2011. There are some alternatives and fixes we have found- please call the Medicare Rights Center to see if we can find a way for you to get Medicare earlier. Tuesday December 7, 2010 12:28 Hannah Oakland

12:29

[Comment From Maria GregorievMaria Gregoriev: ]  I thought that the annual enrollment is now,Nov 15 - Dec 31st. Please verify the dates. Tuesday December 7, 2010 12:29 Maria Gregoriev

12:30

Nathan Heggem:  Yes, you are right. The Fall Open Enrollment period runs from November 15 to December 31. Next year, however, (in 2011) it will run from October 15 to December 7. Tuesday December 7, 2010 12:30 Nathan Heggem

12:30

[Comment From DaveDave: ]  I notice in researching for next year, in my zone, the medicare supplement policies are not covering doctor just hospital. Is thid becomg a trend all over? Tuesday December 7, 2010 12:30 Dave

12:30

Doug Goggin-Callahan:  In most states Medigaps are standardized by letter and in 2011 all the lettered plans cover physicians' services. That said in Massachusetts, Minnesota and Wisconsin the Medigap plans are a little different if you live in one of these states you should call your State Health Insurance Assistance Program (SHIP) to learn more about Medigaps in your state. Go to www.shiptalk.org to find the number for your state's SHIP. Tuesday December 7, 2010 12:30 Doug Goggin-Callahan

12:31

[Comment From Vicki AsburyVicki Asbury: ]  what is the number for Medicare Rights Center to call? Tuesday December 7, 2010 12:31 Vicki Asbury

12:32

Susan Batkin:  Our toll free hotline is 1-800-333-4114. We are open 9-5 eastern standard time. Tuesday December 7, 2010 12:32 Susan Batkin

12:32

Judy Graham:  We've received a few questions about specific states and their relationship to Medicare. We're not going to go into those details here. We do, however, want to direct all of you to an incredibly useful resource available in every state. It's your Senior Health Insurance Counselling Program, often called SHIP. Ask your state's insurance division for information about your state's program Tuesday December 7, 2010 12:32 Judy Graham

12:33

[Comment From StacyStacy: ]  What changes have been made to Medicare after the Affordable Care Act (Health Reform bill)? Tuesday December 7, 2010 12:33 Stacy

12:33

Akiko Takano:  Thanks to health reform, beginning next year, Medicare's coverage of preventive services will get even better. Right now, Medicare covers 80 percent of the cost of just one physical, which you must have within a year of enrolling in Medicare. It doesn't cover any routine physicals after that. But beginning in 2011, Medicare will cover the entire cost of physicals every year. You'll pay nothing. During the annual check-up, your doctor will take some measurements, like your height and weight. You'll discuss your medical history, the medicines you're taking, and care you're receiving from other doctors. Your doctor will also check to see if you are at risk of falling, or have signs of depression or Alzheimer's Disease. There's more good news, which I'll get to in a minute. [hit send] Health reform law also requires that beginning next year, Medicare will cover free of charge any preventive service that is recommended (gets a grade of "A" or "B") by the U.S. Preventive Services Task Force. Here are some services that are partially covered by Medicare now, but will be completely covered and free beginning next year: colorectal cancer screening, cervical cancer screening, diabetes screening, cholesterol and other cardiovascular screenings. For more information, see http://www.healthcare.gov/news/factsheets/pdf/07-14-10_prevention_seniors_fact_sheet.pdf Please note that the law doesn't require Medicare private health plans to cover these preventive services for free, but many already do. Another improvement has to do with Part D. My colleague Nathan will answer that shortly. Tuesday December 7, 2010 12:33 Akiko Takano

12:35

Nathan Heggem:  Yes, as I mentioned above, the doughnut hole will be phased out thanks to health reform. By 2020, the doughnut hole will be completely eliminated. But for now, in 2011, you will receive a 50% discount on brand-name drugs while in the doughnut hole and a 7% discount on generic drugs. The good thing is, both what you pay out of your own pocket AND the 50% brand-name discount will be included in the calculations that determine when you've reached the end of the gap. So if you fall into the doughnut hole next year, you'll pay less and get out more quickly. Tuesday December 7, 2010 12:35 Nathan Heggem

12:36

Judy Graham:  This is a question that came from Susan Boyle, a reader, earlier today. "Are any changes that reduce coverage provided by Medicare taking place?" Tuesday December 7, 2010 12:36 Judy Graham

12:37

Akiko Takano:  There will be no reductions in what Medicare covers. As mentioned earlier, there are improvements to preventive services, and an addition of annual wellness visit, as well as the doughnut hole closure. Medicare private health plans may change the terms of their coverage, as they have from year to year. So it is possible that a Medicare private health plan may discontinue its coverage for an extra service (such as vision care of gym membership) that it had been offering. But be assured that all Medicare private health plans will continue to cover all of the services that are covered by Original Medicare. Tuesday December 7, 2010 12:37 Akiko Takano

12:37

[Comment From DianeDiane: ]  Back to Doug Goggin-Callahan's answer on the late enrollment penalty. Can you explain that? Would there be more than one penalty involved in this man's case? Tuesday December 7, 2010 12:37 Diane

12:37

Doug Goggin-Callahan:  It seems that Tom's father has been disenrolled from Medicare for 8 years. The Part B premium penalty is assessed at 10% of the premium for each 12 months you are not enrolled. So for Tom's father the penalty would likely be 80% of the Part B premium which is approximately $92.00. This would be added onto the 2011 monthly premium of $115.40. So the total monthly premium would be about $207. Tuesday December 7, 2010 12:37 Doug Goggin-Callahan

12:38

[Comment From SusanSusan: ]  Can you tell me when MedPAC published that report on physicians and Medicare? Tuesday December 7, 2010 12:38 Susan

12:38

Akiko Takano:  The report was published on December 2. Tuesday December 7, 2010 12:38 Akiko Takano

12:38

[Comment From CatherineCatherine: ]  You might want to direct people to Medicare.gov for additional resources, online applications etc. Tuesday December 7, 2010 12:38 Catherine

12:39

Judy Graham:  Good suggestion! Tuesday December 7, 2010 12:39 Judy Graham

12:40

[Comment From CarolynCarolyn: ]  I have been told that if I enroll in a Medicare Supplement plan right after I turn 65 I don't have to go through underwriting and I am guaranteed to get coverage. Is this true? And would it be true of a Medicare Advantage plan? Tuesday December 7, 2010 12:40 Carolyn

12:41

Judy Graham:  Give us a moment here folks. We're working feverishly on the questions coming in. Tuesday December 7, 2010 12:41 Judy Graham

12:41

Susan Batkin:  Medicare Advanatage Plans can never impose pre-existing condition rules. As for Medicare Supplement Plans, it varies by STate. CAll your local Ship for more information. Tuesday December 7, 2010 12:41 Susan Batkin

12:42

Judy Graham:  There are a little confusion about enrollment periods a while back. Can any of you address that? Tuesday December 7, 2010 12:42 Judy Graham

12:43

Hannah Oakland:  Sorry- I know this is a confusing point! First, there is a set of enrollment periods to enroll into Medicare A and B. These are generally when you turn 65, your Initial Enrollment Period, or Special Enrollment Periods that generally have to do with retiring or going on COBRA. There is also the General Enrollment Period in which anyone eligible for Medicare can enroll into Medicare Part B. This lasts January to March of each year for coverage beginning in July. There is also a set of enrollment periods that relate to Medicare Part D and Medicare Advantage. The most important of these enrollment periods is now (specifically November 15th-December 31st of each year for coverage beginning January 1st of each year). This is when you can enroll into, disenroll from, or change Part D or Medicare Advantage plans. Tuesday December 7, 2010 12:43 Hannah Oakland

12:44

[Comment From Sarah VSarah V: ]  Is any of this information different for government employees? Tuesday December 7, 2010 12:44 Sarah V

12:44

Doug Goggin-Callahan:  If you have retiree health insurance from the Federal Employee Health Benefits Program (FEHBP) and Medicare, Medicare pays first. Your FEHBP coverage picks up the difference, or in some cases, pays for services not covered by Medicare. Even if you turn down Medicare, your federal insurance will continue to cover you in the same way it did while you were working. Because of this, many people with FEHBP choose not to take Medicare when they first become eligible for Medicare. However, you should evaluate you benefits before deciding to turn down Part B. If you need to enroll into Medicare later you will face a premium penalty for delaying enrollment. Tuesday December 7, 2010 12:44 Doug Goggin-Callahan

12:45

[Comment From Vicki AsburyVicki Asbury: ]  Are their any penalties for doctors who refuse to take medicare patients (like loss of tax deductions??) Tuesday December 7, 2010 12:45 Vicki Asbury

12:45

Hannah Oakland:  The short answer is no, except that they lose a large pool of patients who they can treat. Providers who "opt out" of Medicare cannot bill Medicare, and cannot see Medicare patients and ask them to bill Medicare for them. They can only treat Medicare recipients on a private pay basis. Tuesday December 7, 2010 12:45 Hannah Oakland

12:45

[Comment From Vicki AsburyVicki Asbury: ]  thanks for this chat. I learned a lot of useful information. Tuesday December 7, 2010 12:45 Vicki Asbury

12:45

Judy Graham:  Another good resource for many people is your local Area Agency on Aging. Many people don't know about these organizations but they can be an important source of resources and information about programs, including Medicare. Tuesday December 7, 2010 12:45 Judy Graham

12:46

Hannah Oakland:  You're welcome. And definitely call us with any more questions you may have! Tuesday December 7, 2010 12:46 Hannah Oakland

12:46

[Comment From RichRich: ]  What kinds of premiums or costs are associated with all these different parts? Tuesday December 7, 2010 12:46 Rich

12:46

Akiko Takano:  Part A is free if you've worked and paid your Social Security taxes for at least 10 years. If you haven't, you can still get Part A by paying a premium. Part B has a monthly premium, and the amount varies depending on your income, when you enrolled in Part B, and whether or not you have your premium deducted from your Social Security check. For 2011, the premium will be $115.40 for new enrollees whose income is below $85,000 (for singles) or $170,000 (for couples) and for people who do not have their Part B premium withheld from their Social Security check. People whose income is above $85,000/$170,000 will pay more. There is a chart here: https://questions.medicare.gov/app/answers/detail/a_id/2306/~/2011-part-b-premium-amounts-for-persons-with-higher-income-levels Part D is administered by private health insurance companies, so the premiums vary by plan. Tuesday December 7, 2010 12:46 Akiko Takano

12:46

Judy Graham:  I get the feeling we're coming to the end here. Any more questions? Tuesday December 7, 2010 12:46 Judy Graham

12:47

[Comment From Tom BensonTom Benson: ]  Is this complete chat going to remain on the website for a while? Tuesday December 7, 2010 12:47 Tom Benson

12:48

[Comment From RonnaRonna: ]  Where can we get a transcript of this information? Tuesday December 7, 2010 12:48 Ronna

12:48

Chicago Tribune:  Tom and Ronna, this information will remain online forever. Here's a URL to use and share: http://www.latimes.com/health/chi-health-chat-medicare-120710,0,180552.htmlstory Tuesday December 7, 2010 12:48 Chicago Tribune

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Judy Graham:  Thanks to everyone for tuning in today. Visit us again next week for another Tribune health chat. We'll be doing these weekly going forward and look forward to interacting with all of you many times in the weeks and months ahead. Tuesday December 7, 2010 12:49 Judy Graham

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[Comment From Sarah VSarah V: ]  Thank you so much -- very useful presentation Tuesday December 7, 2010 12:49 Sarah V

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[Comment From Bruce HBruce H: ]  Great Job-Thanks. Tuesday December 7, 2010 12:49 Bruce H

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