Medicare

Medicare is a federal health insurance program for people age 65 and over and for many disabled people. You pay for Medicare through payroll taxes. LMU pays a matching tax. The Original Medicare Plan is Parts A & B and is available anywhere in the U.S. Under these plans, you can go to any doctor or hospital that accepts Medicare patients.

The Four Parts of Medicare

Part A - Hospital Insurance pays some of the costs of hospitalization, limited skilled nursing home care, and hospice care. This plan is premium free. Your enrollment is automatic if you are already receiving Social Security benefits.

Part B - Medical Insurance primarily covers doctor's fees, most hospital outpatient services, and certain related services. Both Parts A and B cover many home health services. Medicare does not cover long-term nursing home care. When you enroll in Part A of Medicare, you automatically enroll in Part B unless you decline it. The basic monthly premium for Part B in 2017 is $134.00

Part C - Medicare Advantage (MA) Plans include Health Maintenance Organization plans (HMO), Preferred Provider Organization plans (PPO), Private Fee-for Service plans (FFS) and Special Needs plans. You must be enrolled in Medicare Parts A & B before enrolling in a MA plan. Most plans require members to visit hospitals, doctors, and other healthcare providers that are approved by the plan.

Part D - Out Patient Prescription Drug Plans voluntary prescription drug coverage. You must have Medicare Part A & B to be eligible. Most MA plans offer prescription plan for an additional premium. Some insurance companies and private businesses are approved by Medicare to sell Part D insurance coverage for outpatient prescription drugs. The basic premium for Part D for 2017 is $34.00 per month. You can call the Medicare office at (800) 633-4227.

IMPORTANT: A Medicare law requires some higher income persons to pay higher premiums. The law applies to premiums for Medicare Part B (medical insurance) and Medicare Part D (prescription drug coverage). The law generally affects individuals with incomes higher than $85,000 and couples with incomes higher than $170,000.

If you are still working and you and/or your spouse are covered by an employer sponsored health plan, you do not need to sign up for Medicare Part B or Medicare Part D. You may however, enroll under Medicare Part A which in most cases, it is premium free. If you enroll in Medicare Part A only, you must actively decline Part B if you are not ready to enroll in this plan.

If you are enrolled in Part B and are working, then Medicare is your secondary payer and it pays only those medical charges not covered by your employer sponsored group health plan. You may also choose not to participate in your group health plan and have Medicare coverage only.

Once you retire, Medicare becomes your primary coverage. If you are a faculty or staff member in a full time benefit eligible status, you may be eligible to enroll in the LMU Post-Retirement Health Plan. Contact the Human Resources Department at (310) 338-2723 for more information.

You may also purchase supplemental retiree coverage from other sources such as through AARP or a Medigap policy (Medicare Supplemental Insurance) from private insurance companies. Often, this may be sufficient to meet most expenses that are not covered by Medicare. Read more and compare Medigap policies.

Helpful Contacts

Note: Some content on this page was gathered from documents from the following websites: