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Show Family TPheJcIySeptember26, 1965 This new law will change the lives of 18 million Americans; here nn Vinw Ho iq au. auiuv va rpnnrt wjhW I VAA UU IT ItJ - - fnrt-fillp- H A A medical benefits will affect your pocketbook X limit, you pay $10 a day. 2. Up to 100 days of care in a qualified nursing home (but you 90-d- ay must first be hospitalized for at least three days). You pay nothing ' the first 20 days; then $5 a day. 3. Up to 100 free home health visits a year by nurses and other health workers, provided that you are homebound and have previously been hospitalized or in a qualified nursing home. : 4. You will be covered for 80 perhoscent of the cost of excess of in testa pital diagnostic the first $20 for tests performed within a y period. You can also enroll in the Supplementary Medical Insurance Benefits plan to help cover doctor? 6tH, whether for home, hospital, or office visits. Many other costs are also covered, such as radiation treatments, the rental of wheel chairs, and the cost of artificial limbs and braces. The plan costs you $3 a month. You pay the first $50 of expenses in-.-.. curred each year, and 20. percent of, the balance. Ufi m what would take place, step by step, in the case of a old widow well call Jane Snyder: For weeks, Mrs. Snyder has been suffering from a severe stomach disturbance. She visits her doctor twice ($10 for two office visits) and, as she becomes worse, he calls at her home eight times ($80). At the end of the month, her bill is $90. Mrs. Snyder has enrolled in the supplementary program. She pays the first $50 of the$90 bia Of the remaining $40 due, she pays 20 percent '($8). . Next month, as her condition fails to improve, the physician suspects cancer and has her admitted to a and hospital There she is given a variety of laboratory testsN Surgery is then recommended. This means' surgeon's fee, operating-roocharges, the cost of an anesthesiologist and a pathologist, medications, blood transfusions, hospital room and board , for nearly two months, and otherservices. The cost of all this care is close' to $4,500. If Mrs. Snyder were only under the out-patie- nt 20-da- 66-yea- r- - ' ed m basic plan, she would, have to pay more than a thirdnearly $1,600. But since she is also protected by the supplementary medical insurance and bad paid the annual deductible of $50, she pays only the $40 hospitalization deductible plus 20 percent of the remaining costs not covered by federal hospital insurance. In all, she pays less than one tenth of the expenses incurred dur- ing her hospital stay. After Mrs. Snyder is discharged from the hospital, she needs further care, so she is transferred to a qualified nursing home, where she stays for 18 days. Ordinarily that would come to $270 at $15 a day. During this time, she is taken to the hospital to receive 10 radiation treatments which cost $100; of this, the radiologist's fee is $40. Her doctor S&6S her four times at the nursing home ($40). When she leaves, all she pays is $16 (20 percent of her doctor's $40 bill and the radiologist's care and $40 bill). The nursing-hom- e radiation therapy are paid for under the government's basic plan. Convalescing, Mrs. Snyder still should have at 'least part-tim-e, postoperative nursing care at home. For 52 visits by a nurse, at a minimum of $5 each, the cost would be $260. Under the basic hospital program, she pays nothing. But her doctor must still see her for a while, .and his bill for 10 visits runs to $100; under the supplementary plan, she pays 20 percent ($20). Mrs. Snyder Is well again. What has Medicare meant to her? The accumulated bills for her illness for doctors, hospital, surgery, nursing home, and home care amounted to more than $5,000, which neither 'she nor her family conceivably could have paid. All she did pay was a little more than $500. x What difference would it make if you only had coverage under the basic plan and passed up the supplementary insur- a nee against doctors' bills, too? ' Consider the experience of John Simmons, 68,x retired construction foreman. He and his wife are living Social Security, on his , . hospital-insuran- ce " $90-a-mo- By THEODORE IRWIN Mrs. Simmons' wife's tary program. With this kit of information will be a card you can use comhis $50 monthly benefit, and, to enroll in the supplementary pro- Mr. Simmons pany pension. Suppose falls one day and fractures his hip, gram, should you -- want thisr too. then contracts pneumonia? . If you are 65 or older, eligible for His bills for hospitalization (34 monthly Social Security benefits, but not receiving cash benefits or still days), surgeon, anesthesiologist, working and not collecting benefits family doctor's calls, and other exyou should apply now at your local penses may run to $2,488 more" Social Security office. You will not than his annual, income of $2,220. be Under the basic required to pass any retirement or he would have to pay earnings test. plan alone, the first $40 of the hospital charges, For the optional doctors' bill for the the plus $785 surgeonand coverage, persons who are 65 or oldto and er and entitled to Social Security $30 speanesthesiologist, cialists for an Xray, lab tests, and benefits will be mailed an application. other doctors' fees a total of $855. Should they decide to take advantage With the supplementary program, he . of it, they should fill out and mail need pay only the $40 deductible, the application. the first $50 for doctors' fees, and 20 People who are 65 or older, but not ' percent ($163) of the remaining eligible for Social Security benefits, should go to a Social Security office surgeon, doctor and specialist fees. to register for the hospital-insThat's with under ance the basic alone. $855 plan and to enroll in the sup- -. plan Heart attacks are common among plementary program. Before next the elderly. Typically, a patient may July 1, when the plans go into effect, the Social Security Administration spend 50 days in a hospital, then 40 will send a card to days in a nursing home. If he is covered by both programs, he is likeeligible persona. Under Medicare, you are free to ly to pay only about $300 out of the select your own doctor. When you aggregate bills of $2,600. Often senior citizens face conpay your $50 deductible in a period siderable hardship when they suffer of illness, notify your doctor and a stroke. In a mild case, the patient ,j show him your card. Either you or he will send future bills to the "carmay spend 16 days in a hospital before he regains his ability to speak rier" who will act as administrative clearly. Involved are charges for agent of the federal government ' radiologist and pathologist services, ... Payments for your hospital and lab tests, and daily physical therapy medical bills (the amount more than in the hospital and at home. the deductibles and other uncovered The records of one recent stroke expenses) will be made through incase showed that the costs for ("cartermediary organizations such hospitalization amounted to riers") such as private insurance $1,464, of which the patient under companies, hospital associations, and .the basic similar groups with experience in replan would pay only $40. For other eximbursing providers of medical serv-iceunder the These organizations will deterpenses, supplementary mine the fees customarily, paid in plan, he would pay the first $50 for doctors' bills, $83 (20 percent), of . your area. the remaining doctors' bills, and $32 And one final reminder if you for medication for a total of $165. wiD be 65 or. older before Jan. 1, If you are 65 or older and are on 1966, and want the supplementary the Social Security rolls and getdoctors' bill protection, you should ting cash benefits, you will receive sign up now, during the first enin the mail sometime "this fall inrollment period which started Sept formation about youi1" new 1, 1965, and ends March 81, 1966. The next general enrollment period protection and the medical costs covered under the supplemen does not begin until Oct 1, 1967. $45-a-mon-th hospital-insuran- ce ur health-insuran- ce , hospital-insuran- ce s. hospital-insuran- ce - ' . feaity W-- W, Spttmbr U, M- S- S |