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It’s no news that Medicare has become almost synonymous with health insurance in the U.S. In fact, as of 2020, 17% of the United State’s total health expenditures were as a result of Medicare Coverage.

This comes as no surprise seeing that every year millions of seniors and disabled receive health insurance coverage under the scheme. As of 2020, Medicare subscribers were estimated to be a little over 62.3 million, and this figure is estimated to rise even more in the coming years.

Since Medicare has become an integral part of our lives, here’s an overview of what Medicare generally covers. Let’s dive in!

What Is Medicare?

Medicare is a federal health insurance program in the U.S. It provides coverage benefits to permanent legal residents and American citizens suffering from End-Stage Renal Disease, those with qualifying disabilities, and those aged 65 years and above.

Medicare comes in different parts. These parts are broadly categorized under the tags “original Medicare,” “Medicare advantage,” and “prescription drug plan.”The different parts offer varying covers to meet people’s health requirements.

Once a person is eligible, he/she can enroll in Medicare. While some people are automatically enrolled in Medicare, others may need to sign up for it. 

Generally, most people end up being automatically enrolled in Original Medicare (i.e., Medicare Part A & Part B).

Medicare is funded through premiums paid by Medicare subscribers, the federal budget, citizens’ Medicare taxes, and social security.

What Are The Parts Of Medicare?

Medicare is divided into four parts, parts A, B, C, and D. These different parts represent the various coverage services offered to Medicare subscribers. Here’s a list of the different parts: 

#1. Medicare Parts A (Hospital Insurance):

Medicare Parts A and B are jointly referred to as Original Medicare. Part A coverage handles a 

Its coverage service includes inpatient hospital stays, hospice care for those suffering from terminal illnesses, care in a skilled nursing facility (SNF) and certain home health care.

Most people don’t pay a monthly premium for Medicare Part A. This is because it is assumed that they must have compensated by paying Medicare taxes while working. This is usually called “premium-free Part A.”

However, if you don’t qualify for this, you can just buy Part A. Although; this will require that you pay about $252- $458 on premiums every month.

#2. Medicare Part B (Medical Insurance):

Medicare Part B provides coverage for outpatient care, certain doctors’ services, medical supplies, and preventive services. Some persons are automatically enrolled in Part B while some others get to sign up for it.

If a person misses the period when they are to sign up, they will have to pay a late enrollment penalty. Generally, everyone gets to pay a monthly premium when using Medicare Part B. 

#3. Medicare Part C (Medicare Advantage):

Medicare Part C provides coverage for costs not covered under Original Medicare. Its coverage usually offers services from Parts A, B, and D, thereby making it more comprehensive. Examples of its extra benefits include hearing, vision, and dental checks.

Unlike Original Medicare, Medicare Advantage is managed by private health insurance firms. However, they are required to adopt Medicare coverage rules.

#4. Medicare Part D (Prescription Drug Insurance):

Medicare Part D helps to cover the cost of prescription drugs. Only private insurers sell the Part D plan. To get Medicare drug coverage, it’s expected that you join a Medicare-approved plan offering drug coverage to its subscribers. 

To learn more about Medicare Parts, refer back to our article here, or get in touch with a licensed Healthcare Search agent today.

What Are The Eligibility Requirements For Medicare?

While we cannot disagree that Medicare has provided insurance coverage to most of the older population in the U.S, the fact still remains that enrollment is no automatic.

Simply put, only qualified persons are entitled to receive Medicare benefits. Two categories of people determine eligibility:

#1. For Those That Are 65 years of age or older

Persons that match the age requirement of 65 years of age will qualify to receive full Medicare benefits if: 

  • He/she is a U.S citizen or has been a permanent legal resident for nothing less than five years
  • Such a person is receiving railroad retirement benefits or Social Security or has been in service long enough to be eligible for such benefits
  • The person or the person’s spouse is a government employee or retiree who, although hasn’t paid into Social Security, has paid Medicare taxes.

#2. For Those That Are Younger Than 65?

Persons below 65 years of age may still qualify for full Medicare benefits if:

  • Such a person has an end-stage renal disease (ESRD)
  • Such a person is permanently disabled and has received disability benefits for nothing less than two years
  • Such a person has ALS (Lou Gehrig’s disease)

Final Word

Medicare can be a daunting maze for those that are not properly guided. You’ll need to take some time to understand the system properly before diving in. To learn more about Medicare and how it relates to you, contact Healthcare Search on this number (985) 273-5822.

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