Here’s Everything You Have to Know About Medicare

January 10, 2018

When people hear the word Medicare, people will automatically think of it as a medical insurance provider for those who are 65 years old and up.

While this is true, there are more to Medicare than it’s common identification. Here are the most important things you need to know about this health insurance program.

Defining Medicare

Medicare is a health insurance program under the federal government that provides coverage to the aged.

The program is administered and made possible by the Social Security Administration and has been operating since 1965.

While the program has been helping countless of individuals for decades now, Medicare does not limit its benefits to the senior population of the country.

People with specific illnesses and disabilities can also qualify for the program. Specific eligibility requirements are discussed below.

Who can use Medicare?

As mentioned, this health insurance program is open to citizens who are 65 and up. Besides that, the program may cover individuals who are experiencing specific illnesses and disabilities.

First, people with End-Stage Renal Disease or ESRD are eligible under Medicare even if they’re still under 65.

Other than that, people who have Amyotrophic Lateral Sclerosis (ALS) or commonly known as Lou Gehrig’s Disease is also eligible.

For individuals who have been accepting disability benefits from Social Security or from the Railroad Retirement Board for the past two years, they may also be eligible for the program.

Keep in mind that this program does not come for free. Those who will sign up for coverage will require monthly premiums depending on their plans.

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Understanding Medicare Plans

The program has different specific coverages under different parts or plans.

Part A covers hospital costs. That means services that are billed directly to the hospital are covered. These may include room and board costs, lab tests, medical supplies, or laboratory tests.

However, Part A does not necessarily limit its coverage with hospital charges. Nursing care facilities, like rehabilitation centers or nursing homes, and hospice or home health services are also covered.

Part A plan holders should understand that this coverage does not pay for your entire hospital or nursing care bill if ever you get admitted. Other services are considered for Medicare Part B.

In a nutshell, Part B plans are responsible for covering costs for outpatient doctor services. Diagnostic or laboratory tests billed directly to the medical practitioner are all considered covered under the plan.

Preventive services, medical equipment, outpatient services, or rehabilitation visits may also be covered.

Part B plans also require premiums unless you qualify for assistance under your state.

Also known as Medicare Advantage, Part C covers services for both services under Part A and Part B.

This plan may also cover routine vision care, together with hearing and dental care. Other than that, this plan may also include prescription drug coverages.

Compared to its Part A and B counterparts, this program has different out-of-pocket charges and your choice of providers or medical practitioners are not the same from the other two.

As Medicare’s prescription drug benefit, Part D covers the medication you take outside of the hospital or doctor’s clinic.

Since its birth in 2006, Part D plans have helped plan holders save money from their prescription drug costs.

Like other health insurance plans, Part D does not cover all medication or prescription drug costs.

Some medication may need permission from your doctor before they will be covered and this plan has set copay amounts for each drug.

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Continuing to provide quality hospital and medical coverage

With all these benefits from Medicare, it’s no secret that the federal insurance agency has been committed to providing assistance for the older population and other qualified individuals for years now.

Especially since qualifying for regular health insurance plans may either be difficult or will require higher premiums as we age.

In the end, Medicare has proven itself to save a lot of individuals from a lot of medical costs thanks to their beneficial coverages.

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