Medicare is a program for health insurance administered by a division under the U.S. Department of Health & Human Services (HHS) and administered by Centers for Medicare & Medicaid Services (CMS). Medicare pays for an assortment of health care expenses as a federal health insurance program. Adults with qualified disabilities or specific medical conditions may be eligible for Medicare. The majority of Medicare recipients are seniors aged 65 and older.
Citizens of the U.S. who have been paying taxes and working a minimum required period of time have earned the right and are entitled to enroll into Medicare. You may be eligible for Medicare even if you don’t think you qualify under the work requirements.
The Medicare program is separated into four parts:
- Medicare Part A – is known as hospital insurance. Medicare Part A covers hospice care, skilled nursing care facility with limited time, home health care services with limited time and inpatient hospital care.
The majority of Medicare Part A recipients typically do not pay a monthly premium to receive coverage. If you have worked and paid Medicare taxes while working for 10 years, you may be eligible for premium-free Medicare Part A.
Generally, Part A will not cover the entire hospital bill and you are responsible for a portion of the costs. You may be required to pay a deductible before you can receive Part A benefits.
- Medicare Part B – is known as medical insurance. Medicare Part B covers non-hospital medical costs such as outpatient hospital care, X-rays, a visit to the doctor’s office and much more. For Medicare part B, you pay a monthly premium. For low-income beneficiaries, Medicaid is available to help cover the costs.
Generally, you are responsible for paying a portion of your health care costs under Part B. You will need to pay for 20% of the bill when you visit a doctor participating in Medicare and the deductible. There are some costs Medicare Part B will completely cover such as doctor requested services, lab tests and others.
- Medicare Part C – is known as Medicare Advantage. Medicare Advantage Plans typically encompasses all types of Medicare coverage in a single health plan. Medicare Part C plans are offered by private insurance companies contracted with the Centers for Medicare & Medicaid Services (CMS) to provide an alternative to Medicare Part A and B. You must have Original Medicare to enroll into a Medicare Part C plan. Medicare Advantage Plans are optional.
Excluding hospice care, a Medicare Part C plan must provide the same benefits as Original Medicare. Medicare Advantage Plans may also include additional coverage which may vary from one private insurance company to another. Prescription drug coverage may be included in many Medicare Advantage Plans known as MAPD. Medicare Part C plans may also include services not included in Medicare Part A or B such as health coverage while traveling outside the USA, eye exams, dental coverage, hearing aids and much more.
- Medicare Part D – is known as prescription drug coverage. Medicare Part D plans are optional and are offered by private insurance companies. Pricing may vary from one private insurance company to another.
Depending on where you live, you may be able to obtain prescription drug coverage under a Medicare Advantage Plan if it is offered in your area. Simply contact us to find out if a Medicare Advantage Prescription Drug plan exists in your area.
You may also qualify for the Extra Help program if you have limited income. The Extra Help program provides financial assistance for those who qualify.