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| Source: CNBC.Com |
American citizens and permanent residents aged 65 years and older can avail of federal health insurance coverage under the Medicare program. Aside from the age requirement, Medicare eligibility is also dependent on one having paid money or taxes into the Medicare program for at least ten years. However, people with a disability or permanent kidney failure can receive Medicare benefits even if they are less than 65 years old.
These benefits include hospital insurance, medical insurance, and prescription drug plans, which are commonly referred to as Medicare Part A, B, and D, respectively. Part C is a recent addition to Medicare, and deals with another type of insurance plan known as the Medicare Advantage plan. The following are some general descriptions of each aspect of Medicare:
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Most people don't have to pay for Part A, since this is already paid for in advance by their Medicare contributions, which are automatically deducted from their paycheck. Medicare subsidizes inpatient costs at hospitals, clinics, or ambulatory surgical centers. It can also be used to help pay for home health care, skilled nursing service and hospice care, provided that certain criteria are met.
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.
Medicare beneficiaries also have the option of receiving their benefits through private health insurance plans, instead of the original Medicare plan. This is the basic definition of Part C or the Medicare Advantage plan. Although these plans are required to have a coverage that is the same, or greater than that of the original Medicare plan, they do not have to cover every benefit in the same way. Usually, only medically essential services are covered and it is possible for the patient to be charged non-standard deductibles, co-payments, or co-insurance for these services.
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Some people perceive the fact that Medicare cannot cover all possible medical expenses of its beneficiaries are perceived as a disadvantage. However, of greater concern is the increasing number of beneficiaries versus the working population, which are basically the source of Medicare funds. It may reach the point where the federal government will no longer be able to support the Medicare program. Some people predict that this situation could come as early as 2018.
On the other hand, for most people, having Medicare benefits to offset medical costs?even partially?is advantage enough. However, to maximize their benefits under the program, beneficiaries should take the time and effort to learn about the Medicare eligibility rules and coverage. Having this knowledge is the only sure way to navigate the sometimes confusing waters that is the Medicare system.
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