Health insurance is a hot topic in the news today. For many Americans, private health insurance options can be very costly and government health insurance does not offer the coverage most people need. Medicare is perhaps the most well known form of government health insurance. However, qualifications for Medicare begin at age 65 or older. The following is a brief synopsis of the Medicare program and how it operates.
Breakdown of the Program
Medicare is, in short, a government health insurance program for individuals age 65 or older. In addition to your age, you must be a U.S. citizen or permanent resident to qualify. The program is divided into four parts and each part covers separate health care areas.
Part A of the Medicare program is the equivalent of hospital insurance. It generally covers hospitalization, nursing facility and home health care in the event of injury or sickness. In the case of terminal illness, Part A of Medicare will also cover the majority of the costs of hospice care. Hospice care is an option that patients with terminal illnesses can choose when medical treatments can no longer provide the help needed to sustain their lives. These patients are diagnosed by doctors to have a very short time to live, often six months or less. Under hospice care, the patients stop taking their medical treatments and the focus of their care majors on providing them with a comfortable environment for their last months on earth. Hospice care can be given at a patient’s home, in a nursing facility or in a family member’s home. Family members or professional caregivers provide them with the care they need and Medicare will cover expenses of medical equipment needed, drugs, etc. until they pass on.
Part B of this government health insurance program covers medical expenses. This will include the services of your doctor, supplies used to diagnose and treat your illness, x-rays, lab work, physical therapy and other forms of outpatient care. Part B can also cover some types of preventative medicines and/or treatment.
Part C of the program is known as the Medicare Advantage program. This part of the Medicare program works in conjunction with private health care systems to provide you with the coverage you need. The private health insurance companies must have prior approval by Medicare to be part of the program. Medicare Advantage will provide both your hospital insurance (Part A) and medical insurance (Part B) in addition to any extra coverage you choose as part of your plan. This extra coverage may include dental care, eye care, ear treatment, etc. Medicare pays a certain amount of funds each month to your private health provider to cover the cost of your care. In exchange, the private health providers have to adhere to specific guidelines put in place by the Medicare system. There are different types of Medicare Advantage plans a person can choose from. Each one may also have their own set of stipulations concerning the care they will provide.
Part D of Medicare deals with coverage of prescription drugs. If you qualify for Medicare, you can take advantage of their prescription drugs insurance coverage by purchasing a premium from a private health provider, which has received Medicare approval. Both Medicare and Medicare Advantage offer prescription drug plans. By researching the features of each plan, you can choose the option best suited for you.
How to Receive Coverage
The requirements for receiving Medicare vary depending on what type of insurance (hospitalization, medical, Advantage program or prescription drugs) you want. Individuals 65 years of age or older that complete with residency requirements, must also have paid social security taxes for ten years to be eligible for Part A of Medicare free of charge. Individuals who have not completed ten years of paying social security taxes can qualify for Part A benefits if they pay a monthly or yearly premium. If you buy Part A benefits, you must also pay for Part B benefits as part of a package deal. Hence, if you want this insurance coverage and you do not qualify for free, you will wind up paying monthly or yearly premiums for both Parts A & B. Some states will subsidize the payment of these premiums if you fall within a low income bracket to help you get the insurance coverage you need.
If you are a legal resident or citizen of the U.S. and are 65 or over, you can qualify for Part B of Medicare for free. Individuals who have been receiving disability benefits from the Social Security office for two years or more can also qualify for Part B Medicare benefits. Others who may also qualify are patients with chronic kidneys diseases, regardless of their age.
Qualifications for Parts C and D of Medicare are contingent on qualifying for Parts A & B. The cost and types of coverage for Parts C and D will depend on the type of plan you choose. As there are quite a variety of these plans to choose from, you will need to research your options and choose accordingly.
Although Medicare offers limited government health insurance coverage because of the age requirement, it is at least a start in helping one group of people get the health coverage they need. Elderly people often have a hard time getting good health coverage solely from private health insurance providers. The free coverage Medicare offers has been a tremendous help for the elderly, so they can get the medical attention they need.