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Consumer Guide To Medicare

New information regarding Private Fee-for Service Plans.

Medicare beneficiaries with Part A and/or Part B are eligible to receive outpatient prescription drug coverage under Medicare Part D. In addition to the voluntary drug benefit, new preventive care services have been added to the overall benefit package to reflect the way medicine is practiced today. The law creating these new benefits in Medicare were signed into law by President Bush on December 8, 2003.

Whether you decide stay in traditional Medicare or choose a PDP, or a Medicare Advantage Plan, is completely up to you.

Most people have saved $1000 onaverage on their prescription drug costs. Many people will also be eligible for further assistance. If you receive a letter from the Social Security Administration, we encourage you to complete the form and return it for processing.

Recent Developments

New Medicare Premium, Deductible, and Coinsurance Charges for 2009

The Centers for Medicare and Medicaid Services (CMS) has announced the new Medicare premiums, deductibles, and coinsurances. For standard Medicare Part B premium, there is no increase for the first time since 2000.

Here are all the new Medicare figures:

  • Part B premium: $96.40/month
  • Part A deductible: $1,068
  • Co-payment for hospital stay days 61-90: $267/day
  • Co-payment for hospital stay days 91 and beyond: $534/day
  • Skilled nursing facility co-payment, days 21-100: $133.50/day
The 2009 Part B monthly premium rates to be paid by beneficiaries who file an individual tax return (including those who are single, head of household, qualifying widow[er] with dependent child, or married filing separately who lived apart from their spouse for the entire taxable year), or who file a joint tax return are:
Beneficiaries who file an individual tax return with income Beneficiaries who file a joint tax return with income Income-related monthly adjustment amount Total monthly premium amount
Less than or equal to $85,000 Less than or equal to $170,000 $0.00 $96.40
Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000 $38.50 $134.90
Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000 $96.30 $192.70
Greater than $160,000 and less than or equal to $213,000 Greater than $320,000 and less than or equal to $426,000 $154.10 $250.50
Greater than $213,000 Greater than $426,000 $211.90 $308.30
In addition, the monthly premium rates to be paid by beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at any time during the taxable year are:
Beneficiaries who are married but file a separate tax return from their spouse Income-related monthly adjustment amount Total monthly premium amount
Less than or equal to $85,000 $0.00 $96.40
Greater than $85,000 and less than or equal to $128,000 $154.10 $250.50
Greater than $128,000 $211.90 $308.30

New Plan Performance Information Now Available
Medicare collects quality assurance information from Medicare plans and providers. Medicare also collects information from people with Medicare about how satisfied they are with those plans or providers. This information about quality is posted at www.medicare.gov. The website has ‘search tools’ that walk you through the steps for getting information you can use to compare what each plan or provider offers in your area.

  • Plan Performance
  • Drug Plan Performance Metrics
  • Click here to learn about several options are available for those who experience coverage gaps.

    There are a number of options for those who have found themselves with a gap in their Part D coverage. This document provides some resources developed by CMS, the agency that runs Medicare, and PhRMA, home to many brand drugs taken by seniors.

    Information for Veterans on the Medicare Prescription Drug Benefit

    Medicare Rx Education Network - This non-partisan network of 40 national organizations representing seniors, patients, people with disabilities and chronic diseases, pharmacists, insurers, healthcare providers, and businesses is chaired by former U.S. Senator John Breaux. The network will share resources, coordinate activities and disseminate information to Medicare beneficiaries and their caregivers about the new Medicare Part D drug coverage.

    Quick facts about Medicare Prescription Drug Coverage: If you have limited income and resources

    Additional Resources

    BenefitsCheckupRx.org assesses current prescription drug coverage and tells beneficiaries what their rights and options are based on their situation.

    The National Alliance for Caregiving is dedicated to providing support to family caregivers and the professionals who help them and to increasing public awareness of issues facing family caregivers.

    Medicare Prescription Drug Improvement and Modernization Act of 2003: Frequently Asked Questions

    Further Help with Your Medicare Questions? - The State Health Insurance Assistance Program (SHIP) has counselors in every State and several Territories that are available to provide free one-on-one help with your Medicare questions or problems.

    MMA Assistance from CMS - This new web page is designed to provide quick and easy access to all activities associated with the Medicare Modernization Act including information on the new drug coverage and low-income subsidy.

    Assistance for Medicare Beneficiaries with Limited Income and Resources - U.S. Social Security Administration

    Find prescription savings programs using the Medicare Prescription Drug Benefit Calculators - Access to Benefits Coalition

    NAHU's Actions

    NAHU Web seminar on Medicare Basics

    Web seminar question & answer session

    Additional Resources

    AARP's Web page on Medicare


    For more information, please contact John Greene.