Medicare 101: Understanding the Basics
9/16/2008 9:53:45 AM
Since being enacted in July of 1965, Medicare has become an important part of American life. According to the Center for Medicare Advocacy, approximately 44.8 million people are expected to be enrolled in Medicare in 2008, up from 43.1 million in 2006. Medicare not only provides healthcare coverage for people aged 65 and older, but also people under the age of 65 with certain disabilities, and people with End-Stage Renal Disease.
While Medicare with its many benefits and parts may seem confusing at first glance, there is a vast amount of information readily available to help you make an informed decision about which plan best meets your healthcare needs. The four major parts that make up Medicare are Part A, B, C, and D.
Medicare Part A covers inpatient hospital services and skilled nursing facility stays. Its benefits also cover some short-term home health care and hospice care, providing certain conditions are met. Part A and Part B Medicare are often referred to as the "Original Medicare". There is no fee for Part A Medicare.
Medicare Part B covers outpatient services such as doctor's visits, lab tests, hospital treatments that are not inpatient, and other basic medical care including preventative services. Part B usually will pay 80% of a service covered by the program and you will be responsible to pay the other 20% along with a yearly deductible amount and a monthly fee.
Medicare Part C or Medicare Advantage plans include both hospital and outpatient services, similar to Part A and Part B, but are provided by private insurance companies that have been approved by Medicare. Most plans will provide you with a list of doctors that are approved by the plan. Usually Medicare Advantage plans require you to see a doctor on their list, or your medical service may not be covered. Additional costs such as copayments, coinsurance, or deductibles are often part of the Medicare Advantage plans. Costs can vary greatly depending on the plan. Prescription drug coverage and dental or vision care may be included in Medicare Advantage Plans at an additional cost.
Medicare Part D is also known as the Medicare Prescription Drug Plan. These plans are optional and are also provided by private insurance companies. Each prescription drug plan will have different costs and will cover different prescription drugs. It is very important to be careful when choosing a Prescription Drug Plan to be sure the prescriptions you are currently using are on the plan you choose and a pharmacy you want to use is also included in the plan. Medicare Part D may not only lower your current prescription drug costs, but it may help protect you against higher costs in the future.
Medicare Supplemental coverage or Medigap plans are provided by private insurance companies. They pay for health expenses that Medicare doesn't cover, such as co-payments. There is an additional cost for these supplemental plans and costs vary depending on the plan you choose.
The first step in choosing any healthcare plan is determining what healthcare benefits you want and need. The coverage you choose will not only affect your current, but also your future health care. Medicare has been a life saver for many older Americans over the years, providing access to affordable healthcare to more older Americans than ever before.
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