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What Is Medicare?

Written By: BenaVest

June 27, 2023

What Is Medicare?

 

The short answer

 

Medicare is a government backed health insurance program that covers people the age of 65 and up. Here are some key factors of Medicare:

 

  • There are different Medicare plans that you can enroll in. depending on your situation one may be better than the other
  • Medicare part A and B can potentially be free and cover the costs of hospital stays and doctor visits
  • Medicare part C does the same as part A and B and many times offer coverage for more things
  • Medicare part D covers the cost of prescription drugs that requires a monthly premium
  • Most people 65 or older qualify for Medicare if they have worked and paid medicare taxes long enough
  • Some under 65 can qualify as well

 

Medicare is a government backed health insurance program that covers people the age of 65 and up. Medicare may also cover some people under the age of 65 if they meet certain requirements.

 

The Different Medicare Plans

Medicare has multiple coverage plans that are named part A, B, C, D. Medicare part A and B are often called original Medicare. Part C may be called medicare advantage. Part D helps cover the cost of prescriptions.

 

Medicare Part A and Part B 

Medicare health plans encompass both Part A (Hospital Insurance) and Part B (Medical Insurance). Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare services. Part B, on the other hand, covers doctors’ services, outpatient care, medical supplies, and preventive services like vaccinations and screenings. These two parts of Medicare are the foundation of healthcare coverage for individuals enrolled in Medicare, and they form the basis of the benefits provided by Medicare health plans.

Medicare Advantage Plans

One type of Medicare health plan is the Medicare Advantage Plan, also known as Part C. These plans are offered by private insurance companies approved by Medicare. They provide all the benefits of Part A and Part B coverage, and often include additional benefits such as prescription drug coverage (Part D), dental care, vision care, and wellness programs. Medicare Advantage Plans come in different forms, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, and Special Needs Plans (SNPs). These plans offer flexibility in choosing healthcare providers and may have lower out-of-pocket costs than Original Medicare.

Other Medicare Health Plans

In addition to Medicare Advantage Plans, there are other types of Medicare health plans available. Medicare Cost Plans allow you to receive services from Original Medicare or a Medicare Advantage Plan, depending on your needs. Demonstrations/Pilots are programs designed to test innovative healthcare models and provide additional benefits to eligible individuals. The Program of All-inclusive Care for the Elderly (PACE) is a comprehensive care option for those who need nursing home-level care but wish to remain in their homes. Each of these plans has its unique features and benefits, providing individuals with various options to suit their specific healthcare needs.

Exploring Options and Joining a Plan

To explore your options and find the right Medicare health plan for you, it’s essential to research and compare different plans available in your area. The Medicare Plan Finder tool on the official Medicare website (medicare.gov) can help you compare plans based on costs, coverage, and quality ratings. You can also contact the Medicare helpline or reach out to a licensed insurance agent specializing in Medicare plans. Once you have made a decision, you can join a Medicare health plan during the annual enrollment period or during a special enrollment period if you meet certain qualifying criteria.

 

Medicare health plans provide a range of benefits that go beyond the coverage offered by Original Medicare. By understanding the options available and evaluating your specific healthcare needs, you can make an informed decision about which Medicare health plan is right for you. Remember to explore your options, determine the costs involved, and take the necessary steps to join a plan that suits your needs and preferences.

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When you are unhappy with the quality of your health care, make sure you speak with your care provider first to let them know about how you feel. If you do not want to talk to your care provider then it is your right to file a complaint.

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