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What is Medicare?

Medicare is insurance that is offered to citizens that are the age of 65 or older, by the federal health insurance program. There are some exceptions to the age specifications. For example, some citizens with disabilities may qualify for Medicare before the age of 65. Another thing to understand is that Medicare has two parts to it. The first being Part A Hospital Insurance and the second is Part B Medical Insurance. Here’s what you need to know about each:

Part A: For this type of insurance there is usually no premium that needs to be paid upfront. This is because the price of the premium is deducted from the taxes of you or your spouse. This works better for some due to the fact that they don’t feel like they have to pay in one lump sum.

Coverage Includes:
  • Inpatient hospital care
  • Critical access hospitals
  • Nursing facilities (not custodial or long-term)
  • Hospice care
  • Some home care

Part B: For this type of insurance citizens pay a premium every month to ensure coverage. Although members have to pay a lump sum every month, there are additional benefits/coverage that they receive.

Coverage includes:
  • Doctor services
  • Outpatient care
  • Physical Therapy
  • Occupational Therapy
  • Some home care

What’s Your Eligibility?

To be eligible for Medicare, in most cases, a citizen or permanent resident of the United States must be 65 years or older and have had employment for a Medicare-covered company for at least 10 years. There may be exceptions for those with disabilities or End-Stage Renal Disease.

If you decide on Part A, you might not have to pay a premium for services if you fall in one of these categories:
  • You or your spouse were employed by a Medicare-covered
    government company.
  • You are eligible to receive benefits though Social Security or the
    Railroad but have yet to file for them.
  • You claim benefits for retirement from the Social Security or Railroad
    Retirement Board.
  • You have been claiming disability benefits for 24 months.
  • You are a patient for a kidney dialysis or kidney transplant.

Be advised, that there is no guarantee that you will be exempt from premiums for Part A coverage, but should you choose Part B you will have to pay. Part B premiums can be deducted various ways, including Social Security, Railroad Retirement, or a Medicare bill.

Medicare Supplement Plans

One of the problems many people face with Medicare are the high costs of deductibles and other costs for basic coverage. This is why some choose to get a secondary insurance to help cover those costs. It works by having Medicare cover costs first and any payment that is left over is covered by the secondary insurance. Some options for this are Medicare supplement plans or Medicare part D.

Supplement Plans

This refers to the insurance that is provided by private companies that help cover any general or excess costs that aren’t covered through Basic Medicare. These companies Medicare approved and charge a monthly premium, that may differ depending what company you choose.

  • Choose any health care provider
  • No referral needed for specialists
  • No deductibles
  • No co-pays
  • No co-insurance

Part D Medicare

This allows members to have prescription drug coverage added to certain Medicare plans. These may include Original Medicare, Medicare Cost Plans, Medicare Private-Fee-for-Service plans, and Medicare Medical Savings Account plans. Medicare approved company’s may offer this private insurance.

Check your coverage

There are many ways to check or inquire about what type of coverage that you have. These include:
  • Your card color (Red, white, or blue Medicare card)
  • Call other insurance providers to understand all coverage.
  • Login to MyMedicare to check your plan.
  • Call 1-800-MEDICARE (1-800-633-4227)
  • Text Telephone (TTY) users may call 1-877-486-2048

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