Medicare includes:
Part A – Hospital insurance
Part B – Medical insurance
Part C – An option to get Medicare through a private insurance company
Part D – Prescription drug coverage.
Medicare Part A works differently than the health insurance plans most of us possess at work, where a premium is paid each month whether we need it or not. Medicare Part A is known as a fee-for-service plan, meaning that you would only be charged once you visit the hospital. Outlining Part A, or hospital insurance, is the simple part.
You have a couple of decisions to make concerning the rest of the Medicare coverage. You have the choice of adding Part B or D, or picking the optional Part C.
Part A covers costs associated with hospital care while Part B covers medical costs like preventive screenings and doctor visits. Similar to Medicare Part A, enrollment in Medicare Part B is automatically processed. However, unlike Part A, it is not free. You’ll pay a premium every month. You can have the option of opting out by getting a hold of your Medicare office and canceling the Part B coverage and picking up a private insurer.
Prescription drug coverage can be covered by choosing Medicare Part D. These benefits will be delivered through private plans which contract with Medicare. Monthly premiums are set for this plan.
Medicare Advantage, or Part C, is an optional plan which mixes the coverage of Parts A and B, yet works similar to the health insurance we get from our workplace. Private insurance companies that are approved by Medicare offer this form of coverage.
An additional difference is that Part C plans often have networks, and once you pick one of these plans, you’ll be required to utilize the hospitals or doctors which belong to that network.
Eligibility
In order to receive Medicare benefits, a person must have resided in America for 5 years and have a permanent residency within the country. Additionally, recipients who qualify should be a minimum of 65 years of age or possess a disability which is permanent. Additionally, any individual who suffers from end-stage kidney disease, needs a kidney transplant, or on dialysis is eligible for Medicare benefits.
Process
In order to get any form of benefits through Medicare, people should apply through a local Social Security office. For those who receive benefits of Social Security, enrollment is automatic when they reach the age of 65. Other individuals must submit coverage application in the period of open enrollment that starts 3 months prior to the individual’s birthday and is completed 7 months afterward.
Medicare isn’t a free program. Indeed, a huge amount of the plan’s costs are paid by citizens of the United States. FICA, also named the Federal Insurance Contributions Act, states that nearly 3% of payroll tax deducted automatically from each person’s paycheck must be utilized for funding the Medicare plan. In turn, this money will pay for the insurance companies which are private, doctors, and hospitals which recipients of Medicare utilize. In total, the plan accounts for around 13% of the federal budget, with a yearly cost that is estimated at $277 billion.