Medicare is federal health insurance program that primarily uses the tax system to finance health care expenses. It was established by the Social Security Act of 1965. To be eligible, a person must be at least 65 years old, have a valid Social Security number, or be an alien who is lawfully admitted for permanent residence and meet other specific requirements, including the requirement that disability had to begin before the age of 65. Medicare consists of Part A, Part B, Part C, and Part D. Here, we will discuss some basic information about each part.
1.Part A – Hospital Insurance
Part A covers inpatient care in hospitals, skilled nursing facilities, hospice care, and a limited number of outpatient services. It will also pay for hospice services if the illness is terminal. The amount paid is determined by your income and the amount of money paid to you or your spouse for medical expenses. To enroll in Part A, you must be a citizen or resident of the United States and have paid Medicare taxes for at least 40 quarters in your lifetime. If you do not meet these requirements, you can still enroll if you either had entitlement to Social Security Disability Insurance benefits for a continuous period of at least 60 months ending with your enrollment date or were eligible for disability benefits because of disability before age 65.
2.Part B – Medical Insurance
Part B is voluntary insurance that covers certain doctor’s services, outpatient care, home health care, laboratory tests, x-rays, and other medical services. The amount it pays varies on your income and other factors. If you enroll in Part B, the federal government pays a percentage of the cost, usually less than what is paid to people who do not register. The best way to determine whether Part B is right for you is to contact your doctor or the Social Security Administration and ask what Medicare coverage would be appropriate. The insurance protects your medical expenses in the future. It pays for necessary tests and examinations to determine what treatment will work best for you. There are no deductibles or coinsurance costs, although you may have to pay some of the cost of certain services out-of-pocket. Your doctor is responsible for submitting bills for all services covered by Part B.
3.Part C – Medicare Advantage Plan
Part C is an optional benefit that allows you to obtain Medicare-covered services from private health insurance companies. Usually, you have to enroll in Part C through a private insurance company that offers it, just as you enroll in Parts A and B directly through the federal government. The benefits under Part C are the same as those under Parts A and B. Copayments, coinsurance, and deductibles usually apply to services under Part C. To determine if Part C is right for you, contact a private insurance company that offers it and see what they can provide you. The companies that provide Part C plans must meet specific requirements based on the amount of money they spend on Medicare-covered services in a year. They are not allowed to put people in plans that would cost more than the actual amount of money they spend. If a plan does not meet these requirements, the company can be fined by the federal government. If you want to get out of your Part C plan at any time, notify the insurance company, and they will stop paying the scheduled benefits.
4.Part D – Medicare Prescription Drug Plan
Part D allows you to purchase prescription medications not covered by other parts of Medicare. These drugs include over-the-counter medications, standard and non-standard prescription drugs, and other types of drugs available through Medicare. Part D plans are optional. They are a good option if you or your family members use a lot of medicine. If you enroll in a Part D plan, the federal government pays a fixed percentage of what the plan charges you for each drug or drug class. The government may also pay a set amount if you have health problems that require special treatments, such as organ transplants or kidney dialysis. To get a Part D plan, you must first enroll in a Part A plan. You also need to have some other health insurance coverage because the Part D plan will work only if you have a policy that covers certain events that can happen to you.
Presently the Medicare coverage is affordable to the citizens of America. The benefit plans have been kept very simple so that the populations can easily understand and avail the benefits accordingly. Since its inception, the program has gone through many revisions because of changes in health care. The government has responded to the changing needs of the American public. That is why Medicare continues to improve its services and make adjustments to give individuals better choices.