Medicare insurance is a type of health insurance that is administered and provided by the United States government. It is intended to provide coverage to those who are over the age of 65 as well as individuals under the age of 65 who are permanently physically disabled. It may also be available to other individuals who meet the government’s strict eligibility requirements.
Over the years, the exact structure of Medicare has changed a few times. When signing up for benefits, patients have choices in terms of coverage and benefits. Today, Medicare insurance is broken up into four parts. Medicare Part A covers hospital insurance, Part B is general medical insurance, and Part D pays for prescription medications. Part D is offered through private insurance companies rather than the government, so plans and benefits can vary greatly. Through Medicare Part C, also known as Medicare Advantage, patients are able to receive the benefits of Parts A, B, and D through private health insurance providers. Plans offered through Medicare Advantage must offer coverage that is equal to or better than the standards of the original program.
Who Qualifies for Medicare
Patients only qualify for the benefits of Medicare when treatments or medications are deemed medically necessary. Elective procedures or prescriptions are not covered by these benefits. Type A covers hospital stays, tests, and doctor’s fees associated with illnesses and injuries. It may also cover short stays in a nursing facility as long as certain conditions are met. Part B typically covers services that are provided on an outpatient basis. It also helps patients pay for medical equipment including wheelchairs, glasses, and prosthetic devices. Because Part C and Part D are administered through private health insurance providers, the plans and benefits vary. Part D plans that cover certain medications that are excluded by Medicare, however, may not permitted to bill Medicare for these products.
Cost of Medicare
Medicare is not free insurance, and it is not intended to cover all out-of-pocket costs. Most recipients do not pay for Part A coverage, but a monthly insurance premium is required for Part B. Premiums may or may not be charged for Part C or Part D Medicare depending upon the insurance provider. In addition to premiums, recipients are also expected to pay deductibles and coinsurance. To help individuals manage the out-of-pocket costs associate with Types A and B, Medicare supplements known as Medigap policies are available through private insurance companies.