Explore Medicare

What is Medicare?

Medicare is a unique federal health insurance program that caters for a list of healthcare costs for a selected class of individuals in the US. It is an entitlement program that is primarily managed by the Centers for Medicare & Medicaid Services (CMS) with most of its beneficiaries being senior US citizens aged 65 and older. Medicare program also suits people with a list of approved medical conditions and disabilities such as Lou Gehrig’s Disease and End-Stage Renal Disease.

It is an entitlement federal health insurance program, which basically means that U.S. citizens are granted the right to access it by working and paying taxes for a given period. In some cases, a person who’s working period has not satisfied the minimum working period is allowed to access the program, but, of course, at a much bigger cost. To cover the services, the Medicare program is split into four different parts.

Parts of Medicare

Part A – Hospital Insurance

Fondly called hospital insurance, Part A covers all the costs incurred when the beneficiary has been admitted to a health facility that includes a skilled nursing facility, hospital or hospice. Fundamentally speaking, it is a cover for all inpatient hospital stays, limited care period in a skilled nursing care facility and hospice care.

Under part A, beneficiaries don’t have to part with a minimum premium, and that’s why it’s sometimes called a “premium-free Part A.” The guarantee takes effect only if you’ve worked for at least ten years and paid your Medicare during the entire 40 quarters. And, concerning the cost, Part A often doesn’t cover the whole medical bill as you would need to pay a deductible fee before the cover takes effect.

Part B – Medical Insurance

It engulfs particular non-hospital medical costs such as X-Rays, Blood tests, Doctor’s visits, diabetic screening and outpatient hospital care. To be eligible, one must pay a monthly premium with the payments varying according to the beneficiary’s income. All Medicare Part B beneficiaries normally have to cover a part of their health care costs. They’ll have to pay a deductible fee before the program takes effect.

Part C – Medicare Advantage Plans

It’s a type of health plan that’s available in private companies with contracts with Medicare to offer parts A and B. Here, enrollment is optional, though one is only eligible if he/she has both A and B. Again, Medicare Advantage Plan provides all benefits of the two, except hospice care. The plan also grants different additional benefits that vary amongst the private health insurers. Some of the advantages following this scheme comprise:

● Health Maintenance Organizations
● Preferred Provider Organizations
● Private Fee-for-Service Plans
● Special Needs Plans
● Medicare Medical Savings Account Plans

Part D – Prescription Drug Coverage

Again, it is an optional program of Medicare that’s available as an individual prescription drug plan in private insurance companies. Fee payments vary, although the fees will be split and shared according to the scheme enrolled. The cost can be deductible, a flat copayment, or a portion of the full drug cost (coinsurance).

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