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‘Welcome to Medicare’

Sue Daugherty • Jun 4, 2014 at 8:10 PM

What is Medicare, and how does it work? '


Since 2011, 10,000 baby boomers per day have been turning age 65. According to the Pew Research Center, this trend will continue until 2030. In the United States, health insurance is provided to people at age 65. It’s called Medicare.


It used to be easy to understand. A Medicare card was sent to you in the mail. You knew if you needed health care, your Medicare card would pay 80 percent of the bill, and you had to pay any deductible plus the 20 percent of the bill Medicare does not pay.

Today it’s not that simple for three reasons:

•Medical technology has made it possible for sophisticated surgeries/ procedures to treat senior citizens for fatal and debilitating conditions like heart surgery, hip surgery and knee surgery — and it’s expensive.

•There are now two forms of Medicare insurance: original Medicare and Medicare Advantage Plans.

•You are receiving lots of mail telling you to buy Medicare products you don’t even understand, and you don’t know what to do. But you can’t afford to be ignorant on this issue.

Here’s why.

As you age, it is not uncommon to undergo sophisticated surgeries that are costly. In some cases, there is an added cost of going through rehabilitation. According to an article in JAMA, “Availability of Consumer Prices from U.S. Hospitals for Common Surgical Procedures” the researchers found prices for various surgeries ranged from $11,100-$125,298.

Medicare doesn’t pay 100 percent of that cost. If the patient is on original Medicare the patient would have to pay their Medicare Part A deductible ($1,216) and 20 percent of the bill. If it was a $100,000 surgery, that means the senior citizen would have to pay $20,000 out of their own pocket. Or, they could purchase a “Medicare Supplemental Insurance Policy” to pay 20 percent of the bill Medicare isn’t going to cover , and I haven’t even begun to discuss the other type of Medicare — “Medicare Advantage Plans” (I won’t either, due to space limitations.)

If I have whet your appetite to want to understand your Medicare coverage, then mark your calendar. At 6 p.m. June 16, there will be a webinar presentation at Serving Our Seniors office, 310 E. Boalt St., Sandusky. Following the webinar presentation, there will be a questionand-answer session with certified OSHIIP Medicare counselor Patti Stineman.

This is not a sales pitch presentation.

Stineman does not sell insurance.

She is a volunteer for the Ohio Department of Insurance, Office of Ohio Senior Health Insurance Information Program, and she volunteers for Serving Our Seniors, advocating for Medicare consumers.

Seating is limited to 13. RSVPs are due by June 12. Call Serving Our Seniors and leave your name, phone number and the name of this event — “Welcome To Medicare”

You are also able to watch the webinar presentation at home on your own computer by registering online at 1. gotomeeting.com/ register/327779641  . However, you will not be able to take advantage of the question-and-answer session with Patti Stineman if you select this option.

Ask Serving Our Seniors

Q: I’m 72 and live in Erie County. I use a wheelchair. Is there transportation for me to get to my doctor appointments, hair appointments, shopping, etc.?

A: Yes. Serving Our Seniors works with Sandusky Transit System. Serving Our Seniors helps to fund the cost of having STS operate throughout Erie County to meet the needs of Erie County senior citizens. Call Serving Our Seniors at 800-564-1856 or 419-624-1856, and we can explain how we can help you get to where you need to go.

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