Medicare is a federal health insurance program available to people 65 years of age or older, as well as to people with certain disabilities such as ALS (Lou Gehrig's disease) and End-Stage Renal Disease.
One of the great things about Medicare is that it offers much flexibility in terms of coverage. You can enrol in a traditional Medicare plan, which includes Part A (hospital insurance) and Part B (medical insurance). Or, you can opt for a Medicare Advantage plan, a type of health plan offered by private insurance companies that contract with Medicare.
No matter which type of Medicare plan you choose, you'll get quality coverage to help you with your medical expenses. So if you're ready to get started with Medicare, be sure to read this guide.
How Does It Work?
The program has 4 "Parts" that cover different healthcare needs and services. Each client chooses the most appropriate "Part" depending on their healthcare needs. Medicare has two main programs that are right for everyone's needs. The two programs are the Original Medicare and Medicare Advantage. When enrolling on Medicare, ensure you get advice from your healthcare provider concerning the options and the plan that is right for you.
What Do Medicare Parts Cover?
Medicare Insurance coverage has two main parts: Part A and Part B. Together; these parts are known as Original Medicare. Additionally, the coverage has a third part, Part C and the fourth one, known as Part D. Here is what each part covers:
Part A
Also known as hospital insurance, it covers any services offered during inpatient visits. Some of the costs catered for include overnight stays in skilled nursing facilities, psychiatric hospitals or any medical hospital. The charges paid include nursing services, the room and meals. It also covers home healthcare and hospice care (especially for patients with chronic illnesses).
Part B
This medical insurance covers all other medical care, such as physician care. It doesn't matter whether you received the care as an inpatient or an outpatient. Every medical care service you receive will be covered under Part B. It also caters for physical therapy, laboratory tests, ambulance costs, and rehabilitation services.
Part C
Part C is also referred to as Medicare Advantage, and it's a private healthcare plan that offers Part A and B benefits. It caters for all services covered by the Original Medicare apart from hospice care. Depending on the plan you choose, it also covers your vision, dental, hearing and any other health expenses. If you select the Medicare Advantage plan, you will have to pay a monthly premium on top of Part B.
Part D
As long as you're a Medicare beneficiary, you can join Part D, which is the prescription drug plan. These plans vary in their benefits and prices, and they cater for various brand names and generic drugs at local pharmacies.
Who is Eligible for Medicare?
Medicare covers people aged 65 and above. You also have to be a citizen or permanent resident of the United States to qualify for Medicare Part A without paying the monthly premium. You're also eligible if you're 65 and receive Social Security or Railroad Retirement Board benefits. This could be based on your work record or someone's record (spouse, widow, widower, divorcee or parent. You also qualify if you or your spouse worked in the government for a long time and Medicare taxes were paid during this period.
Persons under 65 years can also enroll on Part A without paying the monthly premium. The only condition is that you have Social Security or Railroad Retirement Board disability benefits for two years. If you are a kidney transplant patient or on dialysis, you also qualify for this part.
If you don't meet the above criteria, you can still enroll on Part A but have to pay a premium. On the other hand, Medicare Part B is an option, but to enroll, you have to sign up for both Parts A and B. Note that you'll have to pay a monthly premium for Part B, even if you qualify for the free Medicare Part A.
Summary
Medicare comprises four parts: Part A, B, C, and D. Part A covers inpatient hospital care, home health care and skilled nursing facility care. Part B covers outpatient care, including doctor's visits, preventive services, vaccines and tests. Part C, also called Medicare Advantage, is a way to get your Medicare benefits through a private insurance company. Lastly, Part D covers prescription drugs.
To get started with Medicare, you'll need to sign up for Part A or B. You can do this online, by phone, or physically at the local Social Security office. Once you're enrolled, you'll get your Medicare card in the mail. You show this card to your doctor or other health care provider whenever you get care
