Medicare is the health insurance program administered by the United States government to eligible citizens or permanent residents. Medicare eligibility rules are quite simple. To qualify, you must have paid money into the Medicare system for at least ten years. Another condition is that you must be aged 65 or older, unless you have a disability or diagnosed with permanent kidney failure.
Medicare benefits include hospital insurance, medical insurance, and prescription drug plans. These are usually referred to as Part A, B and D. Recently, Medicare coverage is increased to include another type of insurance plan called Medicare Advantage. This is Part C.
Part A: Hospital Insurance. Medicare can help pay for your inpatient costs at a hospital, clinic or ambulatory surgical centers. It can also assist on payments for home health care, skilled nursing service and hospice, provided that you meet additional criteria. This benefit does not require any premium payments since this is already paid for with the Medicare taxes deducted from your paycheck when you were still working.
Most people pay monthly premiums for Part B, which is optional if one is still working or currently employed. However, once one becomes eligible for Medicare, the premium becomes more expensive the longer one puts off making enrolling for this benefit. It subsidizes outpatient costs and some services and products not covered by Part A.
Part D helps pay for prescription medicine and other drugs not covered by Part B. It also provides protection from higher expenses related to this in the future. Also approved and regulated by Medicare, prescription plans are actually administered by private companies.
Part C, or the Medicare Advantage plan, allows Medicare beneficiaries to receive their benefits through private health insurance plans, instead of the original Medicare plan (Parts A and B). These plans are required to offer coverage that is equal or greater than that of the original Medicare program, but they do not have to cover every benefit in the same way. The policies usually cover services that are medically essential and the patient can be charged non-standard deductibles, co-payments, or coinsurance for these services.
However, Medicare is not meant to cover all the medical expenses of its beneficiaries. There is also the concern that the number of beneficiaries will soon outnumber the working population who are the ones funding the Medicare program. Some predict that, if this trend continues, the federal government will not be able to sustain Medicare after 2018 or so.
However, the advantages still outweigh the disadvantages. Beneficiaries should take the time to learn about Medicare eligibility rules and coverage. After all, education is the key in making the most of this program.
There are numerous Medicare plans to decide on including the Medicare Advantage Plan. When you need coverage research Medicare eligibility to see if you meet the requirements.