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How Medicare Works

Centers For Medicare and Medicaid Services 2010 Guide to Medicare
Medicare is the federal health insurance program for people over 65 years of age and people with certain disabilities or End-Stage Renal Disease (permanent kidney failure). There are four parts to Medicare:

  • Part A – Hospital Insurance
  • Part B – Optional Medical Insurance
  • Part C – Optional Medicare Advantage Insurance
  • Part D – Optional Prescription Drug Insurance

2010 Medicare Part A
Helps pay for care in hospitals, some skilled nursing facilities, hospice, and some health care. For most people, Part A is premium-free because they paid Medicare taxes.

Hospitalized

Medicare Covers

Individuals Pay

1-60 days

Most confinement costs after the required Medicare Deductible.

$1,100 Deductible

61-90 days

All eligible expenses, after the patient pays a per-day co-payment.

$275 per Day
Co-payment

91-150 days

All eligible expenses except per-day co-payment. 60 Lifetime Reserve Days may not be reused.

$550 per Day
Co-payment

151 days or more

Nothing

100%

Skilled Nursing Confinement
Must be receiving skilled nursing care in a Medicare approved skilled nursing facility that begins within 30 days after hospitalization of at least 3 days.

All eligible expenses for the first 20 days; then all eligible expenses for days 21-100, after patient pays a per-day co-payment.

$137.50 per-day
Co-payment days 21-100. All costs after 150 days

2010 Optional Medicare Part B
Optional coverage to help pay for doctors, outpatient hospital care, and some other medical services not covered by Part A. The chart below shows the Part B monthly premium amounts based on income. These amounts change each year. There may be a late-enrollment penalty.


If Yearly Income is

Individual Pays 

Single Individual Return

 Married Joint Return

A late fee is possible

 $85,000 or less

$170,000 or less

$110.50*

$85,000 - $107,000

$170,000 - $214,000

$154.70

$107,000 - $160,000

$214,001 - $320,000

$221.00

$160,000 - $214,000

$320,001 - $428,000

$287.30

Above $214,000

Above $428,000

$353.60

* Most people covered in 2009 will continue to pay the 2009 Part B premium of $96.40 in 2010.


Medicare General Enrollment Period is from January 1 through March 31 of each year at a Social Security Administration office. Part B coverage will start on July 1 of that year.
Special Part B Enrollment Periods - while covered by employer or union group health plan or within 63 days of the date when the employer or union group health plan coverage ends, or when employment ends.

Expense

Medicare Covers

Individuals Pay

Medical Expenses
Physician's services for inpatient and outpatient medical/surgical services; physical/speed therapy, diagnostic tests

80% of approved amount

$155 Deductible
plus
20% of approved amount

Clinical Laboratory Services
Blood tests, urinalysis

Generally 100% of approved amount

Nothing for services

Home Health Care
Part-time or intermittent skilled care, home health aide services, durable medical supplies and other services

100% of approved amount; 80% of approved amount for durable medical equipment

Nothing for services; 20% of approved amount for durable medical equipment

Hospital Outpatient
Hospital services for the diagnosis or treatment of an illness or injury

Medicare payment to hospital, based on outpatient procedure payment rates

Coinsurance based on outpatient payment rates

Blood

After first 3 pints of blood, 80% of approved amount

First 3 pints plus 20% of approved amount for additional pints

 

 

 

 

 

 

 

 

 

 

 

Part C Optional Medicare Advantage Plan Monthly
An alternative to traditional Medicare, Part C is another way to get Medicare benefits. It combines Part A, Part B, and, sometimes, Part D (prescription drug) coverage. Medicare Advantage Plans are managed by private insurance companies approved by Medicare. These plans must cover medically-necessary services. However, plans can charge different copayments, coinsurance, or deductibles for these services.

Part D Optional Medicare Prescription Drug Plan
This optional coverage may help lower an individual's prescription

 

Health Savings Account Contribution Limits

Plan
2008
2009
Contribution Limits

$2,900 Single
$5,800 Family

$3,000 Single
$5,950 Family

Minimum Deductible

$1,100 Single
$2,200 Family

$1,150 Single
$2,300 Family

Max out of pocket
includes deductable

$5,600 Single
$11,200 Family
$5,800 Single
$11,000 Family

*Catch Up Contribution Age 55 and older $1000.

Tax Deductions For Long Term Care Insurance

FOR INDIVIDUALS

Premium payments for a tax-qualified long-term care insurance policy
are deductible as personal medical expenses for those taxpayers who
itemize their deductions.


Age
2008
2009
40 & Under
$310
$320
41 to 50
$580
$600
51 to 60
$1150
$1190
61 to 70
$3080
$3180
70 & Older
$3850
$3980

*Prices above are for individuals. Prices for couples would be twice those of
the individuals.

Deductions can be taken for individuals, their spouse and tax dependents
(such as parents) and are subject to the same tax rules as traditional medial
expenses (such as 7.5% adjusted gross income [AGI] floor).

FOR SELF EMPLOYED

Payments for a tax-qualified long-term care insurance policy purchased
by a self employed individual or sole proprietor are currently treated as
medical insurance premiums with the same limits as those for individuals
taxpayers.

FOR C-CORPORATIONS

Premium payments for a tax-qualified [TQ] long-term care insurance policy
are fully (100%) deductible as a reasonable and necessary business
expense similar to traditional health and accident insurance premiums
(IRC Sec 702B[a][3]).

FOR S-CORPORATIONS
LIMITED LIABILITY COMPANIES
PARTNERSHIPS

Premium payments for policies purchased for a non-partner/non-owner or
less-than-2% shareholder-employee are fully deductible as a reasonable
and necessary business expense so long as the entity does not retain any
interest in the policy. The same is true for their spouse or tax dependents.

 

Stark & Associates IRA Fact Sheet

Year
Max Contribution
Catch - Up
Age 50+
Max Contribution with Catch Up
2007
4,000
1,000
5,000
2008
5,000
1,000
6,000
2009
5,000
1,000
6,000
  • Individuals can make a 2008 contribution up until April 15th, 2009
  • Individuals age 50 and above can contribute a total of $12,000 jointly
  • Individuals cannot make an IRA Contribution during the year they turn 701/2.
    Note: If they wait until April 1, individuals must take two distributions during that year. Contributions can be made in 2009 until April 1st for the 2008 tax year.
  • After 2009 figures are adjusted for inflation.

*IRA Eligibility - Limits

Tax Year
Single
Married Filing Jointly
2007
$52,000 to $62,000
$80,000 to $100,000
2008
$53,000 to $63,000
$85,000 to $105,000
2009
$53,000 to $63,000
$85,000 to $105,000


* Please note there is no eligibility limit for self employed individuals.
** The above tax charts are based on current IRS regulations and may be subject to future changes.
***Please note that these figures are subject to change. Please consult your financial advisor.





Business Retirement Plan Contribution Limits

Plan
2008
2009
401(k) and 403(b) Plans
$15,500
$16,500
SIMPLE Plans
$10,500
$11,500
Catch-up Contribution Amounts (for employees age 50 and older)
401(k), 403(b)
SIMPLE Plans
$5,000
$2,500
$5,500
$2,500
Defined Contribution Plans
Lesser of 100% of compensation or $46,000
Lesser of 100% of compensation or $49,000
Defined Benefits Plans
Lesser of 100% of average compensation for high 3 years or $185,000
Lesser of 100% of average compensation for high 3 years or $195,000
Annual Compensation Limit
$230,000
$245,000