What Is Medicare?

What Is Medicare?

Medicare is a government health insurance and a federally funded program divided into various parts that cover different services. It is not to be mistaken with Medicaid, which is for low-income families who meet the requirements. Medicare plans cover the following eligible individuals:

  • Must be 65 years and older
  • Under 65 years old with Social Security Disability Insurance or SSDI for at least two years
  • Under 65 years old with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS) disease
  • Must be a citizen of the United States (with a permanent residence of at least five years)

Parts Of Medicare

Medicare is divided into different plans that cover different healthcare needs. It may not cover everything you need, but it can serve as a primary or backup coverage for long-term medical care. 

  • Part A – Hospitalization

Part A covers basic hospitalization care and other related services. The application automatically enrolls you in this part of Medicare that’s strictly for in-patient care. It also includes hospice or special nursing services for terminally ill patients. Most insured individuals don’t have to pay out-of-pocket because of previous tax deductions from your salary that also goes to Medicare funding. 

But there is a deductible that you must pay each time you have to be in the hospital. For 2021, you’ll pay USD$1,484, which can be covered if you purchase a supplemental Medigap policy to help cover deductibles and other expenses. Some insurance companies may offer Medicare supplemental programs to add to existing coverages. You can click here to find out more. 

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  • Part B – Medical (Doctor Services And Outpatient Care)

This part is significantly costlier than Part A as it covers lab tests, screenings, and other forms of diagnostics, medical equipment, and ambulance service. Signing up for this coverage can be deferred by those who have similar coverages and if covered by spousal medical insurance. If not, you may need to acquire it and deal with the expensive monthly premium at the initial signup. If you have social security and are collecting from it, Plan B has a yearly deductible cost that can be taken from it. The monthly premium may also come higher if your income surpasses USD$88,000.

  • Part C – Medicare Advantage

Plan C includes plans from Medicare-approved coverages from private insurance companies. It is offered to seniors and younger individuals who qualify, serving both plans A and B partially, except hospice care and Plan D drug prescription. There are different Medicare Advantage plans, such as the following:

  • Fee-for-service (FFS)
  • Health Maintenance Organization (HMO)
  • Special Needs Plan (SNP)

Those who need coverage must live in the town where it’s available to service them for Plans A and B. Additional costs in this plan are not covered by Medicare. These can be hearing, dental, and vision. 

  • Plan D – Prescription Drug Coverage

You can acquire Plan D from any private insurance provider. Medicare partially pays for your prescription drugs and vaccines. It also covers coinsurance, copays, and deductibles. Plans vary depending on the cost of drugs, and they can be brand name and generic. On average, it can cost around USD$33 per month. To benefit from this plan as cheaply as possible, sign up right away as soon as you’re eligible because there is a late penalty fee.

In Conclusion

Medicare is a type of government insurance that helps seniors and other individuals with serious illnesses deal with healthcare expenses. The government is funded with a pool of tax dollars to ease hospital, diagnostic, supplemental, and drug prescriptions. Ask your insurance provider if they are Medicare-approved so you can avail of any of the following plans.  

Anna Daniels

Anna is an avid blogger with an educational background in medicine and mental health. She is a generalist with many other interests including nutrition, women's health, astronomy and photography. In her free time from work and writing, Anna enjoys nature walks, reading, and listening to jazz and classical music.

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