abroad or an immigrant.
You’re already enrolled in Medicare but can use some help to troubleshoot problems, find a better deal, or reduce your expenses.
You need a crash course on Medicare issues because you’re helping a parent, relative, or friend navigate the system.
In your job or volunteer time working with seniors or people with disabilities, you can use a plain-language reference to Medicare.
Another point: This book assumes no political standpoints. Medicare has always been a controversial hot potato, gingerly tossed between those who think of it as a social safety net that should be extended to everyone and those who see it as an expensive luxury that is a growing drain on the economy. If you hold strong opinions, fine; that’s your privilege. But in these pages, the only “us versus them” undertone is a bias toward consumers (us) rather than politicians, government bureaucracies, and insurance companies (them). The aim of this book is to help you understand and deal with the system as it is now. If you want it changed — or don’t want it changed — please tell your members of Congress, not me!
Icons Used in This Book
Icons are those cute drawings you see in the page margins now and again. Here’s what they mean.
Beyond the Book
In addition to the material in the print or e-book you’re reading right now, this product also comes with some access-anywhere goodies on the web. For important Medicare dos and don’ts, pointers on enrolling in Medicare at the right time, and key sources of Medicare help, go to www.dummies.com and type “Medicare For Dummies Cheat Sheet” in the Search box.
Where to Go from Here
Nobody expects you to read this book cover to cover. It’s not a thriller or a bodice-ripper! But it does act as a plain-language reference to a program that millions of people use but few understand. So you can jump in anywhere to the bit you need, at whatever point you happen to be when grappling with Medicare. For example:
Want to know how Medicare works? Start with Part 1 to see what Medicare covers, how much it costs, and how you can lower expenses.
Don’t know when you should sign up or how to go about it? Chapters 6 and 7 show you the way, according to your circumstances.
Need to make a choice among Medicare’s many options and private plans? Find out how to do so in Chapters 9, 10, 11, and 12.
Want to get the best out of your Medicare coverage and avoid pitfalls? You’ll find lots of pointers in Part 4.
Part 1
Getting Started with Medicare
IN THIS PART …
Set the record straight on common assumptions and misconceptions about Medicare and how it compares with other types of health insurance.
Discover the basics of Medicare with a quick primer on how it’s divided into four separate programs: Part A (hospital stays), Part B (doctors’ and outpatient services), Part C (Medicare’s private health plans), and Part D (prescription drug coverage).
Find out which services Medicare helps pay for, which services it doesn’t cover at all, and which ones come with certain coverage limits.
Recognize what you’re likely to pay toward your costs in Medicare — the basic premiums, deductibles, and co-payments, plus the premium surcharges you may have to pay if your income is over a certain level.
Get the scoop on ways to reduce your out-of-pocket expenses in Medicare, including special help if your income is under a certain level.
Chapter 1
The Nuts and Bolts of Medicare: What It Is and How It Works
IN THIS CHAPTER
Medicare is a federal government insurance system that helps more than 60 million seniors and people with disabilities pay for their health care. It’s the only truly national health-care program in the United States — meaning that it’s available regardless of your income, the state of your health, or where you live nationwide — and it has been enduringly popular since it began in 1966.
Yet Medicare works like no other insurance you may have known in the past. To avoid total confusion, you’re wise to gain at least a broad understanding of how the program is put together and how its rules may affect you personally.
This chapter provides an overview of the program: addressing common concerns about how Medicare is different from other types of health insurance; describing the four parts of Medicare coverage (A, B, C, and D); and providing a checklist for the decisions that you have to make in choosing among the coverage options that Medicare offers.
