An Overview of Medicare and Retiree Medical Presented at the Pacific Region Retiree Gathering May 26,
Medicare Eligibility
Medicare Parts A, B and D
How to Enroll in Medicare Social Security Administration (1-800)
Medicare Part A – Hospital Insurance Helps pay for: Care in hospitals as an inpatient Critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas) Skilled nursing facilities (not custodial or long-term care) Hospice care Some home health care
Medicare Part B – Medical Insurance Helps pay for: Doctors' services Outpatient hospital care Other medical services that Part A doesn't cover, such physical and occupational therapy, some home health care and supplies deemed medically necessary by a physician
Medicare Coordination Example Enrolled in Medicare Parts A and B Total Hospital & Doctors Charges$22,000 Less Amount Paid By Medicare$19,503 Pfizer Plan Coverage$ 497 Retiree’s Portion (includes deductible & out-of-pocket max) $ 2,000
Medicare Coordination Example Enrolled in Medicare Part B Total Hospital & Doctors Charges$22,000 Less Amount Paid By Medicare$19,503 Pfizer Plan Coverage (Plan pays as if enrolled in Part B) $ 497 Retiree’s Portion (includes deductible & out-of-pocket max) and the portion Part B would have covered $ 2,000
Medicare Coordination Example NOT Enrolled in Medicare Part B Total Hospital & Doctors’ Charges$22,000 Retiree pays Part A deductible Hospital Outpatient & Physician costs (Part B eligible expenses) $ 992 $ 7,000 Pfizer Plan Coverage (Plan pays as if enrolled in Part B) $ 0 Retiree’s Portion (includes deductible & out-of-pocket max) $ 7,000
Retiree Medical and Medicare Coordination of Benefits To receive the maximum benefits available under your Pfizer-sponsored retiree medical coverage you, your spouse or other qualified adult should enroll both Medicare Part A and Part B.
Q & A