Medicare has just celebrated its 50th anniversary. Most people know that Medicare is the government sponsored program to provide healthcare for those who are 65 years of age or older. I will let you decide whether Medicare is a good program or not. However, Medicare is a fact of life and it is something that people need to understand. Like everything else in our society, Medicare has gotten more complex over the years. Therefore, I thought I would do a little Medicare primer to give you some of the basics. Of course I can’t cover all the ins and outs of Medicare, and that is why I encourage you, whether you are presently collecting Medicare or not, to spend some time getting an understanding of the program. The more you understand, the better you will be able to use Medicare to fit your individual situation.
Medicare can be broken down into four basic programs. These programs are Medicare A, B, C and Medicare D.
Medicare A is the basic type of Medicare coverage. When someone turns 65 they are eligible to collect Medicare A without cost. Medicare A is the coverage that you have while you are a patient in the hospital. Typically Medicare will cover the first 60 days of a hospital stay free of charge. If you are in the hospital for more than 60 days, Medicare will partly cover days 61-90. Medicare A also covers your stay in a skilled nursing facility, for limited periods of time, hospice care and some home healthcare.
Medicare B is the coverage for healthcare outside of medical facilities. Medicare B covers such things as doctor visits, out-patient procedures and lab tests. Medicare B can also be used to cover certain medical equipment such as wheelchairs, walkers and scooters. Medicare B is not free and requires a monthly premium. The premium is a sliding scale based upon your income. Typically, you sign up for Medicare B at the same time you apply for Medicare. Medicare Parts A and B typically cover 80% of your medical costs. You will also want to research purchasing what is known as a Medicap plan that will cover the remaining 20% of your medical costs.
Medicare C is also known as Medicare Advantage. This is a type of Medicare program that is offered by private companies and it incorporates Medicare A and B. Typically, Medicare Advantage Plans are HMOs (health maintenance organization) or PPOs (preferred provider organization). Medicare Advantage Plans are offered by such companies as Humana, United Health and Aetna. There are certain minimums that Medicare Advantage Plans must cover, but the scope of the coverage and cost vary. These plans limit your selection of Doctors and facilities to a select network of providers.
Medicare D is the prescription drug coverage and similar to the Medicare Advantage Plans is offered through private insurance companies. With Medicare D there are a variety of plans depending upon your individual situation. In Medicare D Plans, all the plans are based upon a calendar year and there is an open enrollment period, typically in the last part of the year. That is the only time that you can enroll or change your prescription D plan.
It is important for everyone to understand their Medicare coverage and their options. It is important to understand the different coverages and the cost. Particularly, for those people who are still working past 65 and have healthcare coverage at work, it is important to coordinate. In addition, don’t forget that when it comes to choosing a Medicare Plan, not only do you consider cost and coverage, but you also need to consider the quality of care and convenience.
To learn more about Medicare, I would recommend you visit Medicare’s official website at www.medicare.gov. They have a wealth of information on that site and the time you spend understanding Medicare and your benefits could lead you to better coverage, lower cost and ultimately a better quality of care.