Medicare, a health insurance, is financed by the Federal government for the people having age of 65 or above, people having age below 65 with certain deformities and people of any age with ESRD (End Stage Renal Disease) in which a kidney transplant or regular dialysis is required due to permanent kidney failure. All medical expenses are not covered by Medicare; it will help you to pay for health care.
Medicare is financed with monthly premiums taken from Social Security checks and with a fraction of the payroll taxes remunerated by workers and employers. Centers of Medicare & Medicaid Services manage the US Medicare system. Coverage for services and items for more than 43 million recipients is provided by Medicare. Majority of coverage is offered on a local level.
Medicare has 4 parts which cover different types of services with different costs.
Medicare Part A (Hospital Insurance): This Hospital Insurance Medicare is free for nearly everyone who remunerated Medicare taxes. This Medicare coverage helps to cover inpatient hospital care, home health care, hospice care, or skilled nursing facility.
Medicare Part B (Medical Insurance): This Medical Insurance Medicare is for Medicare qualifying people. This Medicare coverage helps to cover hospital outpatient care, doctors' services, home health care and some preventative services to sustain certain diseases from getting worse and for maintaining your health. For Part B coverage, people have to pay $96.40. Though, people having household income above $170,000 and personal income above $85,000 have to pay higher premiums.
Medicare Part C (Medicare Advantage Plans): Medicare Advantage Plans includes Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Special Needs Plans (SNP) and Private Fee-for-Service (PFFS) Plans. Medicare-approved private companies provide these plans. This Medicare covers Part A, Part B, and usually Part D (Medicare prescription drug coverage). You have to pay for Part B coverage with a premium for the plan itself. People having Medicare Part A and Part B can make a choice to receive all of these health care services through one of above provider organizations of Part C.
Medicare Part D (Medicare Prescription Drug Coverage): This Medicare is the newest addition. This gives a prescription drug alternative provided by Medicare-approved private insurance companies. This Medicare coverage helps to cover the prescription drugs cost. This may help to lower the expenses of prescription drug and help to protect against high expenses in the future. It also helps to cover medications cost prescribed by doctors for treatment. If you want to apply for Part D coverage, you must be registered in Medicare. Varying annual deductibles and monthly premiums are included in Part D plans.
People who want to join in Medicare have the advantage of few Coverage Choices for choosing a better option.
You can select Original Medicare which offers Part A and Part B coverage and you can also add Part D to reduce the prescription drugs cost. Part A and Part B Medicare coverage have somewhat gaps between them. Medigap, a Medicare Supplement Insurance may fill this gap. Medical expenses which are not covered by Medicare will be provided by this private insurance plan, Medigap. However, you will need to provide an extra insurance premium, if you register in a Medigap plan.
The other option is Medicare Advantage Plans which are provided by Medicare-approved private companies. HMO and PPO choices are included in this plan which provides both Part A and B coverage. There is no need of Medigap insurance in Medicare Advantage Plans and drug coverage is often included in these plans. The charges for this service are varying by plan and insurance company.
Unlike Medicare Advantage Plans, there is no requirement of Part A in Medicare Cost Plans. Medicare Cost Plans are accessible only in certain parts of the US. You can join this Plan when new members are accepted by plan, otherwise wait for the general enrollment period. Charges of this non-network service are covered under Original Medicare. At any time, you can leave the plan and go back to Original Medicare.
All-Inclusive Care for the Elderly or PACE Programs offers services for weak aged and disabled people having age of 55 and above who are certified by the state as needing nursing home care. You must live in this program offering state for receiving this PACE benefits.
Pilot programs and Demonstrations are offered time to time for testing of Medicare improvements. They are offered only for a limited time period in a specific area, because they are for testing purposes only.
Medicare coverage is commonly confused with Medicaid but Medicaid does not include in Medicare eligibility. Medicaid is a program which is designed by a state-level government for the help of low income families to pay for medical care.
Your medical service or test is covered or not, can be determined on the official site of Medicare. You can use quick search tool for getting answers which you need. You can get relevant information about coverage by entering your exact policy id number at www.medicare.gov/coverage. You have also options of identifying your state and selecting relevant coverage topics for quick search approach. You will get many resources on www.medicare.gov/coverage which helps you to manage your health. For this, check out the sections Manage Your Health, Resource Locator, Medicare Basics, and Help and Support. Prevention works as a best medicine often, so get benefits of these services to live healthy. You can see screenings and measurements covered by Medicare by preventive services checklist. Use the search box if you don’t find the information you are looking for.
Medicare has 4 parts which cover different types of services with different costs.
Medicare Part A (Hospital Insurance): This Hospital Insurance Medicare is free for nearly everyone who remunerated Medicare taxes. This Medicare coverage helps to cover inpatient hospital care, home health care, hospice care, or skilled nursing facility.
Medicare Part B (Medical Insurance): This Medical Insurance Medicare is for Medicare qualifying people. This Medicare coverage helps to cover hospital outpatient care, doctors' services, home health care and some preventative services to sustain certain diseases from getting worse and for maintaining your health. For Part B coverage, people have to pay $96.40. Though, people having household income above $170,000 and personal income above $85,000 have to pay higher premiums.
Medicare Part C (Medicare Advantage Plans): Medicare Advantage Plans includes Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Special Needs Plans (SNP) and Private Fee-for-Service (PFFS) Plans. Medicare-approved private companies provide these plans. This Medicare covers Part A, Part B, and usually Part D (Medicare prescription drug coverage). You have to pay for Part B coverage with a premium for the plan itself. People having Medicare Part A and Part B can make a choice to receive all of these health care services through one of above provider organizations of Part C.
Medicare Part D (Medicare Prescription Drug Coverage): This Medicare is the newest addition. This gives a prescription drug alternative provided by Medicare-approved private insurance companies. This Medicare coverage helps to cover the prescription drugs cost. This may help to lower the expenses of prescription drug and help to protect against high expenses in the future. It also helps to cover medications cost prescribed by doctors for treatment. If you want to apply for Part D coverage, you must be registered in Medicare. Varying annual deductibles and monthly premiums are included in Part D plans.
People who want to join in Medicare have the advantage of few Coverage Choices for choosing a better option.
You can select Original Medicare which offers Part A and Part B coverage and you can also add Part D to reduce the prescription drugs cost. Part A and Part B Medicare coverage have somewhat gaps between them. Medigap, a Medicare Supplement Insurance may fill this gap. Medical expenses which are not covered by Medicare will be provided by this private insurance plan, Medigap. However, you will need to provide an extra insurance premium, if you register in a Medigap plan.
The other option is Medicare Advantage Plans which are provided by Medicare-approved private companies. HMO and PPO choices are included in this plan which provides both Part A and B coverage. There is no need of Medigap insurance in Medicare Advantage Plans and drug coverage is often included in these plans. The charges for this service are varying by plan and insurance company.
Unlike Medicare Advantage Plans, there is no requirement of Part A in Medicare Cost Plans. Medicare Cost Plans are accessible only in certain parts of the US. You can join this Plan when new members are accepted by plan, otherwise wait for the general enrollment period. Charges of this non-network service are covered under Original Medicare. At any time, you can leave the plan and go back to Original Medicare.
All-Inclusive Care for the Elderly or PACE Programs offers services for weak aged and disabled people having age of 55 and above who are certified by the state as needing nursing home care. You must live in this program offering state for receiving this PACE benefits.
Pilot programs and Demonstrations are offered time to time for testing of Medicare improvements. They are offered only for a limited time period in a specific area, because they are for testing purposes only.
Medicare coverage is commonly confused with Medicaid but Medicaid does not include in Medicare eligibility. Medicaid is a program which is designed by a state-level government for the help of low income families to pay for medical care.
Your medical service or test is covered or not, can be determined on the official site of Medicare. You can use quick search tool for getting answers which you need. You can get relevant information about coverage by entering your exact policy id number at www.medicare.gov/coverage. You have also options of identifying your state and selecting relevant coverage topics for quick search approach. You will get many resources on www.medicare.gov/coverage which helps you to manage your health. For this, check out the sections Manage Your Health, Resource Locator, Medicare Basics, and Help and Support. Prevention works as a best medicine often, so get benefits of these services to live healthy. You can see screenings and measurements covered by Medicare by preventive services checklist. Use the search box if you don’t find the information you are looking for.
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