Medicare is a medical insurance program that provides coverage for more than 45 million Americans. The coverage is intended for seniors who are at least 65 years old, individuals younger than 65 but who may have a disability, and individuals, regardless of age, that may have been diagnosed with End-Stage Renal Disease (kidney failure).
What Parts of Medicare are Available?
Medicare comprises four different parts. One part is called Medicare Part A, which provides coverage for a hospital and skilled nursing facility care. Most individuals eligible do not have to pay for this portion. Medicare Part B is optional and it provides coverage for other medically necessary services. For this coverage, most individuals must pay a monthly premium. Medicare Part C is an alternate name for the Medicare Advantage Plan. The newest part of Medicare is Part D, which helps beneficiaries with the costs of their prescription drugs.
What are the Medicare Premiums for 2009?
Most individuals who have Part A do not have to pay for it because they or their spouse have 40 or more quarters of employment that is Medicare covered. For individuals who have between 30 and 35 quarters, the premium is $244 per month. For those who have less than 30 quarters, the premium is $443 per month. The Part A deductible is $1,068 per year as of 2009.
Currently, the premium for Part B is $96.40 per month and the deductible is $135 per year. Once the deductible is met, the beneficiary will pay 20 percent of the Medicare-approved amount.
What is Covered Under the Medicare Plan?
Medicare Part A includes coverage for nursing homes, inpatient care in hospitals and skilled nursing facilities. It also covers hospice care and home health services. Medicare Part B helps to cover most medically necessary and preventative services for beneficiaries. Beneficiaries can receive coverage for services, such as emergency room visits, chiropractic visits, foot exams, eye exams and home health services. Part B also helps to pay for any durable medical equipment that a beneficiary might need. Medicare Part C is a blend of Parts A and B and it helps to cover all medically needed services. With Medicare Part C, individuals are required to use physicians or hospitals within their network. Medicare Part D is the prescription drug coverage that is also provided through these Medicare approved private insurance companies.
What Medicare Advantage Plans?
The Medicare Advantage Plans are also known as Part C. These plans are provided by private insurance companies who are Medicare-approved. The types of Part C plans that beneficiaries can choose from are Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs). Some of the other plans that are included under Medicare Part C are Medicare Special Needs Plans (MSNP), Medical Savings Accounts (MSAs), and Private Fee-for-Service (PFFS). Every Part C plan is different, so it is important to find out the policies before enrolling. Because Medicare Part C is a combination of Part A and Part B, it is not supplemental insurance.
How Can Someone Enroll in Medicare?
If an individual is almost the age of y65 and is receiving Social Security benefits, then he will be automatically enrolled into the Medicare program. Approximately three months before the individual's birthday, he will receive their Medicare card in the mail. If he wishes to opt out of the Medicare Part B portion, he will just need to follow the instructions that were included with their card.
If an individual is almost 65, but does not receive Social Security benefits, then she would have the option of applying for Medicare and Social Security at the same time. These individuals will not be enrolled automatically. To ensure that Medicare coverage begins on time, the individual must apply three months prior to her 65 birthday.
If an individual is younger than 65 or is diagnosed with ESRD, he must make an appointment with the Social Security office in his area to speak with a representative about enrollment.
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