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Americans on Medicare have decisions to make

If you are one of the 39 million Americans covered by the Social Security Administration’s Medicare program, you have probably already received information in the mail about a new set of coverage options available to you within the basic framework of Medicare’s two-part health insurance program.

Medicare is a health insurance program for people 65 years of age and older, some disabled people under 65 years of age, and people with end-stage renal disease (permanent kidney failure treated with dialysis or a transplant).

Medicare has two parts
Part A covers care in hospitals as an inpatient, critical access hospitals, skilled nursing facilities, hospice care and some home health care. There is no premium to pay because you or a spouse paid Medicare taxes while you were working. Everyone older than 65 is automatically covered under Social Security.

Part B helps pay for doctors’ services, outpatient hospital care, blood, medical equipment and some home health services. It also pays for other medical services such as lab tests and physical and occupational therapy. Some preventive services such as mammograms and flu shots are also covered.

Medicare Part B does not cover routine physical exams, eye glasses, custodial care, dental care, dentures, routine foot care, hearing aids, orthopedic shoes or cosmetic surgery. It also does not cover most prescription drugs or health care you get while traveling outside the United States (except under limited circumstances). You are responsible for these yourself.

Participation is voluntary, and a premium is deducted from your Social Security check each month. Currently, the premium for Part B is $45.50 per month, but this may change January 1, 2001.

Now you have three choices
The news is that there are now three kinds of Medicare Part B insurance to choose from, The Original Medicare Plan and two that are provided by private insurance companies -- Medicare Managed Care Plan, and Private Fee-for-Service Plan. Enrollment lasts through the month of November for coverage that begins January 1, 2001.

Full details about these options are found on the Web at the Medicare website. To choose wisely, you need to know the kind of coverage available to you (it can vary depending on where you live), the features of each plan, and what your out-of-pocket costs will be under each option.

For further assistance in making this important decision, you can get personal help by calling 1-800-MEDICARE (1-800-633-4227, TTY/TDD: 1-877-486-2048).

October 26, 2000

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