Medicare refers to health insurance meant for individuals from 65 years and above or people under 65 years with specific disabilities. For example people with permanent kidney failure and needs a kidney transplant or dialysis or those with ESRD (End-Stage Renal Disease). That’s regardless of age.
Medicare has four parts:
Part A (Hospital Insurance). This covers home health care, skilled nursing facilities, hospice and inpatient care in healthcare centers.
Part B (Medical Insurance): Cover outpatient care plus doctors’ services. Part B also covers certain preventive services to improve an individual’s health and prevent certain illnesses from worsening.
Part C is optional and lets you choose to receive all of your health care services through a provider organization (like an HMO or PPO). This is sometimes called Medicare Advantage. You may have lower out-of-pocket costs with this option.
With Part D, prescription drug coverage is added to Original Medicare, some Medicare Medical Savings Account Plans, some Medicare Cost Plans, plus Medicare Private Fee-for-Service Plans. Medicare has approved some private companies and insurance companies to offer these plans.
Factors to Consider When Choosing a Medicare Plan
There are many factors to consider when choosing the best Medicare plan for you. If you want to be sure that your health care needs are being met, you should spend some time evaluating the different plans available. You can also seek Medicare counseling to make the right decision.
To get started on your search for the best Medicare plan for you. Here’s what to consider;
The type of coverage you need
Original Medicare is the federal government health insurance program for Americans age 65 and older who qualify. It includes Part A (hospital insurance) and Part B (medical insurance). In most cases, there are no monthly premiums for Part A. Most people pay a monthly premium for Part B. If you want prescription drug coverage, you must join a separate Part D plan. You can buy a Medigap policy to help pay some of the costs that Original Medicare doesn’t offer.
How much money do you want to spend each month on insurance premiums
You will pay a monthly premium for all plans unless you have Medicaid or other qualifying insurance. The amount you pay depends on what type of plan you choose for each part. Keep in mind, if you’re already enrolled in Medicare Part B (when you turn 65) and want to change to a plan that covers your prescription drugs, you must enroll in a Medicare Prescription Drug Plan (Part D).
The services the coverage offers
Keep in mind that the services offered depend on the type of Medicare plan you choose.
What are the Benefits of Having a Medicare Plan?
The people who get the most benefit from Medicare are those who need it most. If you have a disability or chronic illness, Medicare helps cover the cost of medical bills. It can also help cover prescription drugs and provide rehabilitation services.
It’s important to note that Medicare is not a form of health insurance. It is a form of health care coverage that the federal government provides as part of a larger Social Security program. As part of this program, you pay a monthly premium to receive benefits.
Customized Care Plan
A Medicare plan can be customized based on your needs and budget. You will have the ability to choose the prescription drug coverage level that meets your needs and select the doctor or hospital that you want to visit for treatment. If you want to see a specialist, you will not need to get a referral from your primary care physician.
Access to Quality Care
Medicare provides access to a wide range of health services for seniors and younger adults with disabilities. It covers many medical treatments, including prescription drugs. If you are enrolled in Original Medicare (Part A and Part B), you can see any doctor or hospital that accepts Medicare patients.
Preventive Care Benefits
Medicare offers free preventive screenings and services to keep you healthy. Screenings and tests include yearly wellness visits, mammograms, diabetes screenings, colorectal cancer screenings, flu shots, hepatitis B shots, pneumococcal shots, bone mass measurement tests.
More Affordable Prescription Drug Coverage
Since 2006, all people with Medicare have had access to prescription drug coverage through the Medicare Part D program. With this coverage, most people only pay 25% of the cost of their medication at participating pharmacies or retail stores in their plan’s network.
Peace of Mind
With Medicare as the foundation of your health insurance coverage, you can feel confident you will have access to the health care services you need now and in the future.
Protection against High Costs
Many people are concerned about their ability to afford health care services. Medicare helps by paying for a significant portion of these costs, including doctor visits, hospital stays, and prescription drugs. For those who need it, Medicare also pays for supplemental coverage that can help people with limited incomes or resources pay for health care costs not covered by Medicare.
Key Points to Note
Medicare is a federal health insurance program. Most people qualify when they turn 65. Certain people under 65 with disabilities may also be eligible.
To help pay for Medicare costs, the government takes money out of your paycheck while you work. (This is called withholding.) But many people need help paying for both the Part B premium and other out-of-pocket costs like deductibles and coinsurance.
If you have limited income and resources, you may be eligible for extra help to pay for your Medicare prescription drug coverage (Part D). You can apply online through Social Security’s website
Key Takeaway
When you’re shopping for a health plan, your primary focus should be on what’s in it for you. If you can afford to pay for things out of pocket whenever you get sick, you’re better off with a high deductible plan. Then, if something goes wrong, you’ll pay less each time and won’t bankrupt yourself. If the coverage is right for you, the smaller amount of money will still be enough to go over and above what your plan pays.
But if you expect to need a lot of medical care and want some safety net, it may be hard to figure out what kind of plan is best. The easiest way to handle this is to buy a plan that offers everything and then pick and choose among the services it offers.
