“Just turned 64
this month, so I need to start studying up on Medicare. It
seems so complicated right now. I need to make the right decision.”
– Robert
Medicare was created as part of the Social
Security Act of 1965 that was signed by former President
Lyndon B. Johnson. The first enrollees were former President
Harry Truman and his wife Bess, who both received their
Medicare cards at the bill singing ceremony held on July
30, 1965.
Medicare plans vary and can be confusing
for seniors to understand. Medicare health insurance is
a government program, and is the largest health insurance
coverage plan in the United States with over 50 million
people participating. The eligibility requirements to qualify
for Medicare benefits include being able to answer yes to
one of the following questions:
· 65 years of age or older
· Under 65, but with certain disabilities
· End stage Renal Disease
Medicare has four different parts –
Parts A, B, C, and D. Part A. Part A involves hospital insurance,
Part B is insurance coverage, Part C is advantage plans,
and Part D includes prescription drug plans.
Medicare
Part A
Medicare Part A plans cover overnight hospital
stays that include physician services, tests, food and supplies.
Part A also covers brief patient visits to a skilled nursing
facility. Skilled nursing facility coverage under Part A
lasts for a length of 100 days. The first 20 days are covered
in full with the 80 remaining days consisting of a co-payment
of $142 a day. Many individuals and families opt to have
supplemental coverage to make up for the delta in coverage
after the first 20 days.
Medicare Part B
Medicare health insurance Part B plans cover
some services that are not covered via Part A. It also provides
health coverage for many outpatient needs and services.
Part B coverage consists of medical equipment, x-rays, laboratory
tests, and medication and outpatient services provided in
an outpatient setting. Most people have to pay a premium
to receive Part B coverage. Between Part A and B, most services
and supplies are covered, including preventative services
and home health. Some people may qualify for Part B subsidies
depending on income level. People should keep in mind that
Part B is not a 100% insurance coverage plan.
Medigap or Supplement insurance is designed
to enhance and supplement orginial Medicare and is a good
idea to have to cover what could be a financial disaster
for you if you suffer a major accident or serious illiness
not covered by Medicare. Supplement insurance is private
health insurance from an insurance company like Aetna, Humna
or United Health Care to name a few. For more information
about Medicare Supplement insurance check these sources:
Medicare
Part C
Medicare Part C is referred to as Medicare
Advantage plans. Part C plans combine Parts
A and B coverage, but are offered by private insurance companies.
In many cases, Part C plans are more affordable than original
Medicare plans and have better coverage. Part C plans include:
· Medicare Preferred Provider Plans
· Medicare Health Maintenance Organization
· Private Pay
· Special Needs
· Medicare Savings Accounts
Medicare Part D
Medicare prescription drug coverage Part D is an important
part of any health plan because of the rising cost and increased
use of prescription medication. Part D coverage provides
prescription drug benefits by private insurance companies
approved by Medicare. Many people who are on Medicare Advantage
(Part C) plans probably already have Part D coverage. For
those who do not have Part C coverage, you typically have
to pay a separate premium.
For additional information on a specific term related to Medicare visit our Glossary of Medicare Terms page, which explains terms used in the Medicare program.