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Medicare in Illinois – Illinois Medigap

Medicare Supplemental Insurance in IL

Medicare in Illinois is health insurance for is for those 65 or older and for those under 65 with certain disabilities and any age with End Stage Renal Disease. You also must have entered the United States of America legally and have lived here for at least 5 years to be eligible for Medicare.

Medicare in Illinois consists of four parts: Part A, Part B, Part C and Part D.

Original Medicare is administered by the federal government, which has two parts. Part A and Part B.

Part A is hospital insurance in Illinois.

which will pay for impatient care you will receive in an hospital, home health care, hospice care, and skilled nursing facility if you meet certain conditions. Most individuals do not have to pay a monthly premium for Part A because he or she or a spouse paid Medicare taxes for 40 calendar quaters while working in the United States. If you are not eligible for premium-free Part A, you might be able to to buy Part A if you meet the following requirements:

You are under 65, disabled and your premium-free Part A coverage ended because you returned to work. (If you are under 65, disabled you can continue to get premium-free Part A for up 8.5 years after you have returned to work.

You are 65 or older, you are entitled to or enrolling in Part B and you meet the residency or citizenship requirements of Illinois.

Part B of Medicare in Illinois.

will cover medical services such as medical services, doctor services, outpatient care, and home health services. Part B will also cover some preventive services. There is however; a monthly premium for Part B. The standard Part B premium in 2011 was $115.40. However, there was no Social Security cost-of-living adjustment in 2011. Therefore, most individuals with Medicare are already enrolled in Part B in 2010, with a income of that is below $85, 000 for each individual or $170,000 for married couples, will pay the same premiums in 2011 as they were paying in 2010.

Part C is Medicare Advantage Plans.

These plans are offered by private insurance companies and are approved by Medicare. In order to qualify, you must already be enrolled in Part A and Part B. The plans will provide all your Part A and Part B services and will generally provide additional services. People usually have to pay a monthly premium and copayments that are likely to be less than the deductibles and coinsurance under the original Medicare. In most cases, the plans will offer Part D prescription drug coverage. Benefits and cost will vary by plan.

The different types of Medicare Advantage Plans in Illinois are:

  • Health Maintenance Plan (HMO)—A HMO has a network of specialists, hospitals, primary care doctors that you must go to. Most Plans under HMO will require referrals to see these specialists.
  • Preferred Provider Organization (PPO) Plans–Is a plan that has a network of hospitals, specialists, primary care doctors that you most go to. With PPO plans you flexibility to go to any health care provider that is not on your list. However, it will cost more.
  • Private Fee-for Service (PFFS) Plans is a plan that you will receive care from any Medicare-approved provider such as a hospital or doctor who before you are treated will agree to accept the terms of Medicare Private Private Fee-for-Service Plan’s conditions and terms of payment. If the provider does not agree to the conditions and terms of payment the provider should not provide services to you unless it is an emergency and you will be able to find another provider who will accept the conditions and terms.
  • Special Needs Plans (SNP) is a plan for people who have ceratin conditions or chronic diseases or who have specialized needs.
  • HMO Point of Service (HMOPOS) Plans is a HMO plan that allows you receive out-of-network services at higher costs.
  • Medical Savings Account (MSA) Plans is a plan that will combine high deductible health plan with a bank account. Medicare will deposit money into an account and you may use this money to pay for health care services during the year.

Part D

Part D of Medicare in Illinois is prescription drug plans offered by private insurance companies which are approves by Medicare. There are currently two ways to receive Medicare prescription drug coverage:

  • Medicare Prescription Drug Plans–These plan will add dd drug coverage to Original Medicare, Medicare Medical Savings Account (MSA) Plans, some Medicare Cost Plans, and some Medicare Private Fee-for-Service (PFFS) Plans.
  • Medicare Advantage Plans with this you will get prescription drug (Part D) coverage all of Part A and Part B Coverage through these plans. Medicare Advantage Plans that has prescription drug coverage will sometimes be referred to as MA-PD’s.


Medicare in Illinois – Illinois Medigap – Medicare Supplemental Insurance in IL

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