How Medicare Pays

Medicare Explained

How Medicare Pays

The way Medicare pays is, you generally pay a set amount for your health care (deductible) before Medicare pays its share. Then, Medicare pays its share, and you pay your share (coinsurance / copayment) for covered services and supplies. There is no yearly limit for what you pay out-of-pocket. You usually pay a monthly premium for Part B. You generally don’t need to file Medicare claims. The law requires providers (like doctors, hospitals, skilled nursing facilities, and home health agencies) and suppliers to file your claims for the covered services and supplies you get.

Medicare pays for only a portion of your hospital and medical bills. As with many private insurance plans, the government expects beneficiaries to pay a share of their bills. Medicare Parts A and B both have deductibles and coinsurance. The deductibles for 2017 are $1316.00 per Benefit Period, for Part A. A benefit period begins the day you are admitted as an inpatient in a hospital or skilled nursing facility (SNF). The benefit period ends when you have not received any inpatient hospital or SNF care for 60 days in a row. Therefore, it is possible to have multiple Part A hospital deductibles in the same year. In 2017 the Part B deductible is $183.00 per year. There is two types of private insurance  available to cover all or part of these out-of-pocket costs. These insurance plans are called Medicare Advantage (the Part C of Medicare) or Medicare Supplements (also called Medigap or Medsup Plans).

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Sonia Ashford is “The Medicare Insurance Lady”. Sonia has been helping Medicare eligibles all over Texas with their Medicare Insurance since 2005. She has been married to John Ashford since 1982 and they currently reside in Bedford, Texas. They have six adult children as well as nine adorable grandchildren that they love to spoil. Some of Sonia’s favorite hobbies are quilting, scrapbooking, and crafting. They also have several pets at home including freshwater fish and a Havanese Shih Tzu named Precious.

Sonia H. Ashford is the owner of the Independent Marketing Organization Ashford Insurance. Sonia has delivered countless speeches to senior citizens about turning 65, Medicare Advantage, and Medicare Supplement Insurance Plans. Sonia has spoken at local small group meetings and to individual consumers in TarrantDallas, and surrounding counties. To many, she is a respected and trustworthy agent within the Medicare Insurance industry.

Sonia specializes in Texas Medicare Plans including Medicare Advantage Plans from UnitedHealthcare® Medicare Solutions as well as Medicare Supplement Insurance Plans (Medigap or Medsups) and Part D Prescription Drug coverage from several top insurance carriers.

Ashford Insurance’s office is centrally located in Hurst, Texas within Tarrant County, in the heart of the Dallas / Fort Worth Metroplex also known as HEB, or Mid-Cities. She would love to come to visit with you or have you come by the office and see how she can help with your Medicare insurance decisions.