Medicare's unfunded obligation is the total amount of money that would have to be set aside today such that the principal and interest would cover the gap between projected revenues (mostly Part B premiums and Part A payroll taxes to be paid over the timeframe under current law) and spending over a given timeframe. By law the timeframe used is 75 years though the Medicare actuaries also give an infinite-horizon estimate because life expectancy consistently increases and other economic factors underlying the estimates change.
Because of how Part D works and depending on income, a patient could pay between 35 percent and 85 percent of the cost of some of their prescription drugs if they need enough medication to push them into the notorious doughnut hole, when Part D's full prescription-drug coverage runs out after a person has spent $3,750, until their medication costs exceed $5,000 per year. (In 2019, coverage will end at $3,750 and begin again at $5,000.) During the coverage gap, the patient would be responsible for 25 percent of covered, brand-name prescription drugs.
The Initial Enrollment Period is a limited window of time when you can enroll in Original Medicare (Part A and/or Part B) when you are first eligible. After you are enrolled in Medicare Part A and Part B, you can select other coverage options like a Medigap (Medicare Supplement) plan from approved private insurers. The best time to buy a Medigap policy is the six month period that starts the first day of the month that you turn 65 or older and enrolled in Part B. After this period, your ability to buy a Medigap policy may be limited and it may be more costly. Each state handles things differently, but there are additional open enrollment periods in some cases.
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Basic Plan helps cover Medicare's Parts A and B coinsurance, hospice care coinsurance, skilled nursing facility coinsurance, Home Health Care Services, Medical Supplies, and foreign travel emergency care. Extended Basic Plan provides the same benefits listed for the Basic Plan, plus benefits for Medicare's Part A hospital deductible, Medicare's Part B deductible, non-Medicare eligible expenses, and preventive medical care when not paid by Medicare.
Parts B and D are partially funded by premiums paid by Medicare enrollees and general U.S. Treasury revenue (to which Medicare beneficiaries contributed and may still contribute of course). In 2006, a surtax was added to Part B premium for higher-income seniors to partially fund Part D. In the Affordable Care Act's legislation of 2010, another surtax was then added to Part D premium for higher-income seniors to partially fund the Affordable Care Act and the number of Part B beneficiaries subject to the 2006 surtax was doubled, also partially to fund PPACA.

As always, you’re welcome to find current information on Medicare Part C plans in Minnesota, prescription drug plans, and Medicare supplement plans by using our online quote forms. If you have questions, you’re also welcome to use the toll-free phone number to call a licensed agent. We can help you if you’re just turning 65 years old or want to learn about options for Medicare replacement plans.


If you decide to sign up for a Medicare Advantage plan, you may want to shop around, because costs and coverage details are likely to vary. Our obligation-free eHealthMedicare plan finder tool on this page lets you see all available Medicare Advantage options in your area, including a list of coverage details once you click on the plan of interest.
The expenditures from the trust funds under Parts A and B are fee for service whereas the expenditures from the trust funds under Parts C and D are capitated. In particular, it is important to understand that Medicare itself does not purchase either self- administered or professionally administered drugs. In Part D, the Part D Trust Fund helps beneficiaries purchase drug insurance. For Part B drugs, the trust funds reimburses the professional that administers the drugs and allows a mark up for that service.

With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were formally given the option to receive their Original Medicare benefits through capitated health insurance Part C health plans, instead of through the Original fee for service Medicare payment system. Many had previously had that option via a series of demonstration projects that dated back to the early 1970s. These Part C plans were initially known in 1997 as "Medicare+Choice". As of the Medicare Modernization Act of 2003, most "Medicare+Choice" plans were re-branded as "Medicare Advantage" (MA) plans (though MA is a government term and might not even be "visible" to the Part C health plan beneficiary). Other plan types, such as 1876 Cost plans, are also available in limited areas of the country. Cost plans are not Medicare Advantage plans and are not capitated. Instead, beneficiaries keep their Original Medicare benefits while their sponsor administers their Part A and Part B benefits. The sponsor of a Part C plan could be an integrated health delivery system or spin-out, a union, a religious organization, an insurance company or other type of organization.
As a Medicare beneficiary, you may also be enrolled in other types of coverage, either through the Medicare program or other sources, such as an employer. When you first sign up for Original Medicare, you’ll fill out a form called the Initial Enrollment Questionnaire and be asked whether you have other types of insurance. It’s important to include all other types of coverage you have in this questionnaire. Medicare uses this information when deciding who pays first when you receive health-care services.
This link is being made available so that you have an opportunity to obtain information from the third party on its website. It is provided as a convenience and not as an endorsement of the content of the third party site or any products or services offered on that site. We do not take responsibility for the products or services offered or the content on any linked site or any link contained in a linked site. 

We are not an insurance agency and are not affiliated with any plan. We connect individuals with insurance providers and other affiliates (collectively, “partners”) to give you, the consumer, an opportunity to get information about insurance and connect with agents. By completing the quotes form or calling the number listed above, you will be directed to a partner that can connect you to an appropriate insurance agent who can answer your questions and discuss plan options.
The Minnesota Department of Commerce: provides beneficiaries with information about Medicare Part D Prescription Drug Plans and other insurance options available to them. The office is a resource for information about protection from Medicare fraud and how to report fraud. Additional links are included for federal offices that deal with Medicare and brochures that explain how to enroll in Part D Prescription Drug Plans. This government office also offers downloads of premium guides for supplemental plans available to current Medicare beneficiaries in Minnesota.

Part B coverage includes outpatient physician services, visiting nurse, and other services such as x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor's office. It also includes chiropractic care. Medication administration is covered under Part B if it is administered by the physician during an office visit.

Choice: Medicare Advantage plans generally limit you to the doctors and facilities within the HMO or PPO, and may or may not cover any out-of-network care. Traditional Medicare and Medigap policies cover you if you go to any doctor or facility that accepts Medicare. If you require particular specialists or hospitals, check whether they are covered by the plan you select.


**NY: In New York, the Excess Charge is limited to 5%; PA and OH: Under Pennsylvania and Ohio law, a physician may not charge or collect fees from Medicare patients which exceed the Medicare-approved Part B charge. Plans F and G pay benefits for excess charges when services are rendered in a jurisdiction not having a balance billing law; TX: In Texas, the amount cannot exceed 15% over the Medicare approved amount or any other charge limitation established by the Medicare program or state law. Note that the limiting charge applies only to certain services and does not apply to some supplies and durable medical equipment; VT: Vermont law generally prohibits a physician from charging more than the Medicare approved amount. However, there are exceptions and this prohibition may not apply if you receive services out of state.
We are not an insurance agency and are not affiliated with any plan. We connect individuals with insurance providers and other affiliates (collectively, “partners”) to give you, the consumer, an opportunity to get information about insurance and connect with agents. By completing the quotes form or calling the number listed above, you will be directed to a partner that can connect you to an appropriate insurance agent who can answer your questions and discuss plan options.
If you decide to sign up for a Medigap policy, a good time to do so is during the Medigap Open Enrollment Period, a six-month period that typically starts the month you turn 65 and have Medicare Part B. If you enroll in a Medigap plan during this period, you can’t be turned down or charged more because of any health conditions. But if you apply for a Medigap plan later on, you may be subject to medical underwriting; your acceptance into a plan isn’t guaranteed.

As of 2016, 11 policies are currently sold—though few are available in all states, and some are not available at all in Massachusetts, Minnesota and Wisconsin. These plans are standardized with a base and a series of riders. These are Plan A, Plan B, Plan C, Plan D, Plan F, High Deductible Plan F, Plan G, Plan K, Plan L, Plan M, and Plan N. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies in the same state. Unlike public Part C Medicare health Plans, Medigap plans have no networks, and any provider who accepts Original Medicare must also accept Medigap.
This link is being made available so that you have an opportunity to obtain information from the third party on its website. It is provided as a convenience and not as an endorsement of the content of the third party site or any products or services offered on that site. We do not take responsibility for the products or services offered or the content on any linked site or any link contained in a linked site.

If you have special health care or financial needs, you may qualify for a Special Needs Plan. All Special Needs Plans include drug coverage. Other benefits may include coordination of care, transportation to and from medical appointments, credits to buy everyday health items, and routine vision and dental coverage. There are four main types of Special Needs Plans:
Health Maintenance Organization (HMO) plans: One of the most popular types of managed-care plans, this type of Medicare Advantage plan comes with a provider network that you must use to be covered by the plan (with the exception of medical emergencies). If you use non-network providers, you may have to pay the full cost for your care. You’re also required to have a primary care physician; if you need to see a specialist, you’ll need to a get a referral from your primary care doctor first.
A Medicare Advantage Health Plan (Medicare Part C) may provide more help at a lower cost than traditional Medicare plus Medigap. Instead of paying for Parts A, B, and D, a person would enroll through a private insurance company that, in many cases, covers everything provided by Parts A, B, and D and may offer additional services. The beneficiary would pay the Medicare Advantage premium along with the Part B premium in most cases.
* NY: In New York, the Excess Charge is limited to 5%; PA and OH: Note: Under Pennsylvania and Ohio law, a physician may not charge or collect fees from Medicare patients which exceed the Medicare-approved Part B charge. Plans F and G pay benefits for excess charges when services are rendered in a jurisdiction not having a balance billing law; TX: In Texas, the amount cannot exceed 15% over the Medicare- approved amount or any other charge limitation established by the Medicare program or state law. Note that the limiting charge applies only to certain services and does not apply to some supplies and durable medical equipment; VT: Vermont law generally prohibits a physician from charging more than the Medicare-approved amount. However, there are exceptions and this prohibition may not apply if you receive services out of state.

****Medically Necessary Emergency Care in a Foreign Country: coverage to the extent not covered by Medicare for 80 percent of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first 60 consecutive days of each trip outside the United States, subject to a calendar year deductible of $250, and a lifetime maximum benefit of $50,000. For purposes of this benefit, “emergency care” shall mean care needed immediately because of an injury or an illness of sudden and unexpected onset.
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