Much of the confusion about Medicare comes from not knowing how it works. We break down what this US Federal health insurance program entails and how it functions. This will equip you with the tools you need to find the right health care plan.
Americans over 65 are entitled to Medicare and can enroll for it in the initial enrolment period. The perfect time to enroll is in the three months before your birthday month. If you miss this time, you can enroll in the general enrolment period (Jan 1st to March 31st). The special enrolment period takes special circumstances into account and the time period varies depending on the circumstances. People under 65 who have disabilities, ALS (Lou Gehrig’s disease), or end-stage renal disease are also entitled to Medicare.
There are four types of Medicare programs titled Parts A, B, C, and D. Part A, also called hospital insurance, covers hospital stays. Part B (or medical insurance) covers reduced-cost health care services like visits to a doctor. Part C or the ‘Medicare Advantage Program’, has the benefits of both A and B as well as a portion of Part D. Part D covers the cost of prescription drugs.
Parts A and B are called Original Medicare. Though they cover a fair amount of medical services and supplies (about 50 %) you may need a supplemental plan to get a more robust coverage. That’s where Parts C and D come in. These additional plans are offered by a private insurer but regulated by the government. They address some of the gaps in Original Medicare. For instance, Part C offers Dental and Vision care.
How much you pay for Medicare depends on a combination of factors such as the plan you choose, your income, and what supplemental policy you choose. Part A is free if you or a spouse have over 40 quarters of Medicare-covered employment under your belt. Premiums for Medicare part B and D depend on your income, but the standard starts at $135.50 per month. There is a range of premiums and plans available for Medicare Part C. A Medigap policy, which also has a range of premiums can also be purchased to supplement Original Medicare.
