What is Medicare?
What is Medicare?
Medicare is a Federal health insurance program administered by the United States government that pays for hospital and medical care for elderly and certain disabled Americans.
This health insurance program comprises of 2 main parts. Part A includes hospitals and Part B is for medical insurance. There are 2 additional parts also. Part C provides for flexibility and Part D for prescription drugs.
Medicare Part A (Hospital Insurance) covers your inpatient care in hospitals, critical access hospitals, and skilled nursing facilities. It also covers some home health care such as physical, occupational, and speech therapy that is provided on a part-time basis and deemed medically necessary. Certain medical equipment for the aged and disabled such as walkers and wheelchairs are also covered by Part A. Part A is generally available without having to pay a monthly premium since payroll taxes are used to cover these costs.
Medicare Part B is also known as Supplementary Medical Insurance (SMI). It helps pay for physician visits, outpatient hospital visits, home health care costs, and other services for the aged and disabled.
Part B covers:
- Durable medical equipment (canes, walkers, scooters, wheelchairs, etc.)
- Physician and nursing services
- X-rays, laboratory and diagnostic tests
- Certain vaccinations
- Blood transfusions
- Renal dialysis
- Outpatient hospital procedures
- Some ambulance transportation
- Immunosuppressive drugs after organ transplants
- Chemotherapy
- Certain hormonal treatments
- Prosthetic devices and eyeglasses
A monthly premium of $96.40 per month (in 2009) was required under Part B and an annual deductible of $135.00 (in 2009) was to be met by the patients before the coverage actually begins. Enrollment in Part B is voluntary.
Medicare Advantage Plans (sometimes known as Medicare Part C) allow users to design a custom plan that can be more closely aligned with their medical needs. Private insurance companies are enlisted to provide some of the coverage, but details vary based on the program and eligibility of the patient. To provide preventive health care or specialist services, some Advantage Plans team up with Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). Others focus on patients with special needs such as diabetes.
In 2006, Medicare expanded to include a prescription drug plan known as Medicare Part D. Prescription drug coverage under a Part D is eligible for individuals if they are entitled to Medicare Part A benefits and/or enrolled in Part B. Part D is administered by one of several private insurance companies, each offering a plan with different costs and lists of drugs that are covered. Participation in Part D requires payment of a premium and a deductible.
References:
- What are Medicare and Medicaid? - (http://www.medicalnewstoday.com/info/medicare-medicaid/)
- Medicaid - (http://en.wikipedia.org/wiki/Medicaid)
- Medicare (United States) - (http://en.wikipedia.org/wiki/Medicare_%28United_States%29)
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Hannah Punitha. (2017, April 19). What is Medicare?. Medindia. Retrieved on Jul 03, 2024 from https://www.medindia.net/health/insurance/what-is-medicare-and-medicaid-what-is-medicare.htm.
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Harvard
Hannah Punitha. 2017. What is Medicare?. Medindia, viewed Jul 03, 2024, https://www.medindia.net/health/insurance/what-is-medicare-and-medicaid-what-is-medicare.htm.