What Do Medicare Plans Actually Cover?

Medicare, which was launched in 1966, is the national health insurance program for people over 65 years old and is administered by the United States federal government’s Social Security Administration. It is funded by worker payroll taxes, taxes from beneficiaries and a few government subsidies. The overarching goal of Medicare is to cover enrollees over 65 years old for at least half of their healthcare costs while they cater for the other half out-of-pocket.

 

As already mentioned, in order to qualify for Medicare, one has to be 65 years of age or older or be receiving social security disability or have End Stage Renal Failure. The program is divided into Medicare Part A, Part B, Part C, and Medicare Supplemental Insurance Policies including Medicare Plan D, prescription drug coverage.

 

Understandably, Medicare is designed to defray healthcare costs for seniors and those with certain disabilities. Initially, Medicare consisted solely of hospital insurance and medical insurance but was later adjusted to cover additional expenses with the purchase of additional insurance called Medicare Supplemental Insurance Plans.

 

Medicare Part A is actually hospital insurance and covers anyone who is found eligible. It covers mostly inpatient care including hospital stay, skilled nursing facilities, and care, and hospice facilities with some home health care also included. It is not intended to cover custodial or long-term care. The good news about Medicare Part A is that enrollees need not pay a premium for this portion.

 

Part B is termed medical insurance. Its goal is to cover medically-necessary services such as lab tests, doctors’ services, diagnostics, therapy and general outpatient care including some preventive screenings. It is intended to cater for portions of Medicare that Part A does not cover. Enrollees have to pay a premium for Medicare Part B although it is optional

 

Medicare Part C is also known as Medicare Advantage. It is said to contain more or less the same coverage and enrollee gets from Medicare Parts A and B and supplemental insurance plans. The only difference is its benefits are administered by private insurers rather than the federal government. Enrollees, in turn, pay their premiums directly to this private insurer. Medicare Part C is optional as well and enrollees can opt for it instead of Part A and B.

 

Medicare Advantage has often been referred to as supplemental insurance because it covers the gaps left by Medicare. The difference between Medicare Advantage and Medicare Supplemental Insurance Plans, Medigap, is that Medigap coverage is purchased in addition to Original Medicare coverage. An enrollee has the option to choose one or the other with the difference being benefits are administered by the private entity rather than Medicare itself. Many people view Medicare Advantage plans (Part C) as subtle replacements for Parts A, B, and D.

 

Medicare Plan D involves prescription drug coverage and is only offered through private companies which are government-certified and approved by the Centers for Medicare and Medicaid Services, it is just one of ten Medicare Supplemental Insurance Plans available to Original Medicare Part A and Part B enrollees. It is also optional, and enrollees have to pay a premium directly to the private insurance company.

 

Learn more about Medicare Supplemental Insurance plans, rates and more at http://www.emedicare-supplemental-insurance.com.  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 877-202-9248 today!

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