Medicare 101: Either you are close to the age of 65, deciding to buy Medicare or you are here just to acquire a clear understanding of Medicare. Both ways, this blog will definitely help you.
Knowing about Medicare and every part of it will help an individual to make the right pick. So, keep reading!
It is a well-known national health insurance program for the citizens and some permanent legal residents of America. In the present age, over 60 million U.S citizens are enrolled in Medicare.
There are certain basic eligibility criteria to qualify for Medicare. When a person turns 65, he or she can avail this plan depending on his or her employment record or that of his/her spouse.
In addition to this, people under the age of 65 who have qualifying disabilities are covered by Medicare, too.
Children with serious health issues who are about to turn 18, it’s vital to examine whether they should register for Medicare. According to the Affordable Care Act, people can cover their children under their own policy up to age 26.
At the same time, Medicare has also changed over the years. Today, it has a total of four parts. Some of them are compulsory, others are optional.
PART A: Hospital Insurance
This part of Medicare primarily covers the hospitalization expenses. When a person enrolls in Medicare, he/she automatically acquires Part A.
Following are some of the services mainly covered under part A:
- doctor visits
- Inpatient care in hospitals
- Skilled nursing facilities
- In-home hospice care
- Home healthcare services
- Inpatient care
This plan may seem straightforward; however, it is not.
For instance, Part A covers in-home hospice care but not a stay in a hospice facility. Besides, if a person is hospitalized, a deductible is applied, and if he/she stays for over 60 days, then he/she may have to pay Part A for each day. That implies, if you get admitted to a hospital numerous times in a year, then you will have to pay a deductible every time.
PART B: Doctors & Tests
This part provides coverage for a number of medical services such as:
- Doctor’s visits
- Medical equipment
- Outpatient care
- Outpatient procedures
- The purchase of blood
- Cardiac rehabilitation
- Cancer treatment.
A person who doesn’t have “creditable coverage” from any other source should enroll in Part B.
On the other hand, if a person doesn’t enroll and doesn’t have creditable coverage from any other source, then he or she will have to pay a hefty penalty.
The deductible for Part B coverage is $198. When a person pays the deductible, he or she will have to pay 20 percent of the Medicare-approved expense of the service.
PART C: Medicare Advantage
This plan is also termed as Medicare Advantage. It is another option for traditional Medicare coverage.
Part C coverage is a mixture of both Parts A and B. This coverage is administered by private insurance firms that usually collect Medicare payments from the federal government.
It completely depends on the plan if a person wants to pay an extra premium for Part C.
One doesn’t have to enroll in an advantage plan. However, for many individuals out there, Part C is a better deal than separately paying for Parts A, B, and D.
Read More: Best Medicare Advantage Plans
PART D: Prescription Drugs
Prescription drug coverage is also known as Part D. This coverage is administered by private insurance firms.
Part D is provided to people who have a prescription drug plan from any other source such as any Medicare Advantage plan.
It completely depends on the plan if a person is supposed to meet an annual deductible before his or her plan starts.
Medicare plans also have a coverage gap, i.e. a temporary limit on what the drug plan will actually cover. This gap is often termed as the doughnut hole. It kicks in after a person spends a certain amount in combined expenses.
In order to close the aforementioned gaps, you can enroll in some form of Medigap insurance or in a Medicare Advantage plan.
Keep in mind that Medigap only supplements Medicare. Never, consider it a stand-alone plan. Also, if your physician doesn’t accept Medicare, then Medigap insurance will also not provide any coverage.
Now that you learned all four parts of Medicare, we hope you will pick the right plan for yourself.