When US citizens turn 65, they become eligible for Medicare. Medicare is divided into several parts. Medicare Part A is hospital insurance, while part B covers the medical side. Medicare Part C plans, also known as Medicare Advantage, allow people with Parts A and B coverage to opt for for coverage through a provider organization if available in their area. Part D pays for some prescription drugs and medications.
Coverage
Medicare Part B covers preventive and medically necessary services. Preventive services totally or partially paid for by Medicare Part B include such items as annual flu shots, breast cancer screenings, biannual bone mass measurement, cardiovascular screening every five years, and a one-time abdominal aortic aneurysm screening. Medicare defines medically necessary services as those needed for diagnosis or treatment of a medical condition meeting generally accepted medical practice standards, as well as any required supplies.
Eligibility
Upon turning age 65 and collecting Social Security payments, recipients automatically get Part A and Part B Medicare insurance on the first day of the month in which that birthday falls. Those over age 65 still at work and not collecting Social Security benefits do not automatically receive Medicare, but must contact Social Security to enroll in Medicare. Patients of any age suffering from end-stage renal disease and requiring either dialysis or a kidney transplant are also eligible for Medicare Parts A and B.
Payment
Most Medicare recipients do not pay for Part A insurance, but do pay monthly Part B premiums. The total costs of Part B premiums are subsidized by the federal government. Higher-income individuals pay higher Part B premiums. In 2011, the standard premium is $115.20 for individuals with incomes of less than $85,000 annually and couples earning less than $170,000 --- the same payments as the previous year. Individuals and couples with higher incomes based on federal tax returns pay between 30 and 85 percent of the the total Part B costs with less of a government subsidy.
Enrollment Periods
After becoming eligible for Part A Medicare, individuals have an seven-month "initial enrollment period" for Part B sign-up. Enrolling for Part B in the initial enrollment period, which begins three months before the 65th birthday with coverage starting the month of the birthday and lasting for three months after the birthday, results in lower premiums and faster coverage eligibility. Those who miss the initial enrollment period may sign up for Part B annually between January 1 and March 31, but must pay premium increases of 10 percent for each year the person was eligible for Part B Medicare but chose not to enroll.
Tags: Medicare Part, enrollment period, initial enrollment, initial enrollment period, Part Medicare, Part premiums
