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Understanding Basic Medicare

Understanding Medicare

Many people might be familiar with Medicare as coverage for major medical situations, such as hospitalization or emergency services. But there is much more to Medicare. Understanding the different parts of Medicare can be difficult. Each component means something different for your health care and your financial bottom line.

A General Explanation of Medicare

Medicare is a health insurance program administrated by the federal government. It is designed to help those over the age of 65. If you are 65 or older, a permanent resident of the United States, and worked in Medicare-covered employment for at least ten years, you should be eligible for Medicare. In addition, individuals with certain disabilities are also entitled to it, including those with Lou Gehrig’s disease and advanced kidney failure.

Understanding the different parts of Medicare can be confusing. Here is a brief overview of the different Medicare “parts” and a few optional plans:

Medicare Part A

When you check into a hospital or long-term care facility, the admission is covered under Medicare Part A. Short-term rehabilitative care in a skilled nursing facility and hospice care all fall under Medicare Part A as well. It is free for participants, and most people are automatically enrolled at the age of 65.

Medicare Part B

When you visit your doctor, have outpatient tests, or receive other medical care that doesn’t require checking into the hospital or skilled nursing facility, Medicare Part B kicks in. Though coverage is available for everyone who qualifies for Part A, Medicare Part B requires an annual deductible and a monthly fee.

Medicare Part D

Medicare Part D is for prescription drugs. The plans are run by private insurance companies, so the amount of coverage may vary from one plan to another. Financial help might be available for those who can’t afford the full cost of the prescription plans.

What about Other Medicare Plans?

There are several other plans that are often considered part of Medicare, but might not be. Here are a few of the most common plans often mistaken for Medicare:

  • Medi-Cal. This is not part of the Medicare plan. Medi-Cal is for those who have medical need but have low incomes and cannot afford medical care or long-term care.
  • Medigap. This is also known as Medicare Supplement insurance. These plans are administered by private insurance companies and cover the costs that Medicare does not. The cost depends upon the plan chosen. You can buy a Medigap policy to pay for Original Medicare deductibles, co-payments, co-insurance, and other costs.
  • Medicare Advantage. These are Medicare plans, but they are managed by private insurance companies. They might restrict the doctors you can see, and they usually cost more. However, these plans can combine Medicare Part A, B, and D into one package, which might make several aspects of care easier.

Medicare can be confusing, but your Social Security office is trained to help you with any questions you might have. If you have any questions about eligibility, coverage, and what you might have to pay, contact them at your earliest convenience.

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