Medicare is a federally funded insurance program that was established in 1964. The following groups of people may be eligible to receive benefits:
• People who are at least 65 years old
• People under 65 who have specific disabilities
• People of all ages who have permanent kidney failure requiring dialysis
Individuals who are still working at 65 should enroll in Medicare Part A in order to receive benefits for expenses not covered by private insurance. A variety of private plans, called Medigap, that were designed to cover temporary gaps in benefits or supplement uncovered benefits are available to meet specific needs.
Medicare is divided into four categories and pays some of the costs for each of the following needs:
• Part A - in-patient hospital care, hospice, skilled nursing facilities, home health care
• Part B - out-patient hospital care, visits to doctors' office, home health care; some expenses not covered by Part A
• Part C - certain kinds of preventive care; also called Medicare Advantage Plans
• Part D - prescription drugs from companies approved by Medicare; help with prescriptions; possibly lowers prices of prescription drugs; also called Medicare prescription drug coverage
Although the Medicare system cannot be easily summarized in one short description, there are a few basic facts that make the research go a little more smoothly:
1. Medicare and Medicaid are two entirely different programs. Unlike Medicare, Medicaid is administered by the state and helps to pay for specific needs of people with low incomes. Some people, however, meet the requirements for both programs.
2. Medicare's preventive services are designed to prevent illnesses from occurring or from worsening. These services may include information, screenings, vaccinations, and tests that help to maintain healthy lifestyles. Patients who have had Part B for 12 months qualify for a yearly "wellness" visit.
3. Medicare-approved private insurance companies provide coverage for Medicare C and D. These plans may involve additional costs.
4. Physicians are required to file claims for patients covered under Original Medicare. Doctors are not required to file claims for patients who have Medicare Advantage because medical providers receive small payments monthly from these insurance companies.
5. Medicare does not usually pay for custodial care provided by nursing homes. However, patients who qualify for Medicaid may be eligible for these services.
Negotiating the benefits and yearly changes of health insurance can be time-consuming and confusing. For detailed information and answers to specific questions, visit medicare.gov or call 1-800-Medicare.
About this Author
Joann Carlisle is a writer who enjoys sharing her knowledge and advice with readers. For more on health care, Finance Dad offers readers tips for ways to cut health care costs.
• People who are at least 65 years old
• People under 65 who have specific disabilities
• People of all ages who have permanent kidney failure requiring dialysis
Individuals who are still working at 65 should enroll in Medicare Part A in order to receive benefits for expenses not covered by private insurance. A variety of private plans, called Medigap, that were designed to cover temporary gaps in benefits or supplement uncovered benefits are available to meet specific needs.
Medicare is divided into four categories and pays some of the costs for each of the following needs:
• Part A - in-patient hospital care, hospice, skilled nursing facilities, home health care
• Part B - out-patient hospital care, visits to doctors' office, home health care; some expenses not covered by Part A
• Part C - certain kinds of preventive care; also called Medicare Advantage Plans
• Part D - prescription drugs from companies approved by Medicare; help with prescriptions; possibly lowers prices of prescription drugs; also called Medicare prescription drug coverage
Although the Medicare system cannot be easily summarized in one short description, there are a few basic facts that make the research go a little more smoothly:
1. Medicare and Medicaid are two entirely different programs. Unlike Medicare, Medicaid is administered by the state and helps to pay for specific needs of people with low incomes. Some people, however, meet the requirements for both programs.
2. Medicare's preventive services are designed to prevent illnesses from occurring or from worsening. These services may include information, screenings, vaccinations, and tests that help to maintain healthy lifestyles. Patients who have had Part B for 12 months qualify for a yearly "wellness" visit.
3. Medicare-approved private insurance companies provide coverage for Medicare C and D. These plans may involve additional costs.
4. Physicians are required to file claims for patients covered under Original Medicare. Doctors are not required to file claims for patients who have Medicare Advantage because medical providers receive small payments monthly from these insurance companies.
5. Medicare does not usually pay for custodial care provided by nursing homes. However, patients who qualify for Medicaid may be eligible for these services.
Negotiating the benefits and yearly changes of health insurance can be time-consuming and confusing. For detailed information and answers to specific questions, visit medicare.gov or call 1-800-Medicare.
About this Author
Joann Carlisle is a writer who enjoys sharing her knowledge and advice with readers. For more on health care, Finance Dad offers readers tips for ways to cut health care costs.