What is Medicare? Medicare is a health insurance program that is primarily offered to seniors who meet the minimum age requirements but it is also available to younger individuals who have certain disabilities and medical diagnosis. While the available Medicare coverage in your state is primarily determined by Medicare plans participating in the program, you have more control over your health care insurance, as you can select the plan or plans that fit your health care needs best. Medicare plan options include Medicare Part A, Medicare Part B, Medicare Part C and Medicare Part D insurance. Each Medicare plan will include a different level and type of coverage. While almost everyone receives Medicare Part A for free, you will generally be expected to pay for all other Medicare plan options. Find out more about expected costs for Medicare enrollment by downloading our comprehensive guide.
If you have Medicare Part A included in your Medicare Plan, then you will generally receive inpatient hospital stay coverage and some health care coverage. Medicare Part B will provide coverage for general health services, including visits to your physician. It is important to know that Medicare Part B does not include prescription drugs, dental care or vision care. Medicare Part C combines Medicare Part A and Part B coverage. Part C plan options can also include dental care, vision care and even prescription drugs depending on the specific plan selected. It is worth noting that Medicare Part C requires that you already have Medicare Part A and Part B. Medicare Part D is available for prescription drug coverage. However, if you are receiving a Medicare Part C plan that already receives drug coverage, then you will not be eligible for Medicare Part D. It is important for you to know what Medicare plans cover so you can have the medical services at an affordable rate.
In addition to finding information about Medicare costs and coverage, you should be aware of the enrollment periods. If you do not enroll in a Medicare plan when you first become eligible, then you may be subject to late enrollment fees when you do apply. Find out more Medicare information within the outlined topics below.
What are the requirements for Medicare?
It is important to understand the Medicare eligibility requirements prior to submitting an application. Guidelines on eligibility for Medicare enrollment are federally mandated and clearly stated for any potential applicants. Not only do these set Medicare qualifications determine whether you can obtain Medicare coverage, but they also outline the costs you will be expected to pay for your Medicare plans.
How to Apply for Medicare
There are several ways to sign up for Medicare once you determine you are eligible to apply for coverage. You must know when to submit your Medicare application, as there may be penalties when you apply after your initial enrollment period. When you apply to Medicare, you should understand the documentation that you may be required to present as well as the different application methods that are available to you.
Learn About Medicare Costs & Coverage
Understanding Medicare costs and the coverage options that are available to you is a crucial part of obtaining Medicare health insurance. Medicare coverage is broken down into several “parts” (A, B, C and D) with each providing a different type of coverage and having varying costs. Knowing what the Medicare premiums and copayments are for each part can help you determine which coverage works best for your budget.
How to File Medicare Claims and Appeals
Usually, the medical provider submits a Medicare claim, but there are sometimes when you can or must submit a claim. You can file a Medicare claim form whenever a decision has been made by Medicare, your Medicare health plan or the prescription drug plan that you disagree with, such as a decision on covered services, payment obligations and a change to your existing Medicare. The process of completing a Medicare claim form and submitting an appeal is different depending on the part of Medicare you are subscribed to, so it is crucial that you understand the claim and appeal process that will affect your Medicare health insurance.
What is Medicare Part A?
Medicare Part A is part of the original Medicare plan, which consists of both Part A and Medicare Part B. Medicare Part A plans provide coverage for a variety of medical services and needs, but it does not comprehensive and beneficiaries should know which health care services are covered by Part A before enrolling. Medicare Part A plans cover a variety of services and needs ranging from medical professionals, medicine and other forms of care and equipment. Likewise, the Medicare Part A cost can vary between enrollees. For some senior citizens, Part A of Medicare may not have a monthly premium. Petitioners who do not meet the qualifications for premium-free Part A Medicare will have to pay a fee each month.
What is Medicare Part B?
Medicare Part B, when combined with Part A, is considered ‘Original Medicare.’ Medicare Plan B targets its coverage to help you with services and supplies that are deemed medically necessary by your physician to treat whatever ailments or conditions you may be suffering from but are not covered under Part A. Medicare Part B plans cover or help to cover various services considered preventative care intended to head off serious maladies or detect them in early stages of development so they can be treated before leading to serious or even catastrophic health circumstances. Included in the items covered in Medicare Part B are things such as outpatient services that you might receive in your doctor’s office, at a clinic or some other facility that is not categorized as a hospital.
What is Medicare Part C?
Medicare Part C is also referred to as a Medicare Advantage Plan. Medicare Part C plans are available through private insurance companies of which Medicare approves. You must first have both Medicare Part A and Part B to obtain coverage under Part C. You will still be a member of the Medicare network, but a private insurance company will administer your coverage and benefits instead of getting what is referred to as ‘Original Medicare.’ Medicare Part C, or Medicare Advantage, includes plans you may be familiar with like a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO) or Private Fee-For-Service administered by private insurance companies such as Cigna or Blue Cross. All Medicare Advantage plans through these private insurers must be approved by Medicare.
What is Medicare Part D?
Medicare Part D is also called the Medicare prescription drug benefit. This is because Medicare Part D plans provide prescription drug coverage to enrollees who subscribe to a Medicare plan. To receive Medicare Plan D, an individual must subscribe to an insurance plan run by an insurance company or other private entity approved by Medicare. Different Medicare Part D plans may cover different drugs, so it is important to make sure the plan you choose covers the prescription medicine that you need. If you are concerned about the Medicare Part D cost, then you should be aware that late enrollment in a plan can result in a penalty that will increase the premium. However, prescription coverage may be available through Medicare Part C plans.
Learn About the Program of All-Inclusive Care for the Elderly (PACE)
The Program of All-Inclusive Care for the Elderly (PACE) is a system that provides comprehensive medical and social services to senior citizens. PACE services aim to assist those in need of help and to address their health care needs in their communities as opposed to providing them in a nursing home or other assisted living facility. The PACE program uses a team of health care professionals to coordinate with families to ensure the proper regimen of care is provided. Individuals typically qualify for PACE if they are considered to be frail and meet the eligibility requirements for Medicare and Medicaid benefits. PACE centers that provide the staff and service must meet the state and federal safety guidelines.
Find Out About Hospice Care
What is hospice care? Understanding hospice care and why it is significant can be helpful for many family members in charge of end-of-life care for their loved ones. It is also important to know when to consider hospice care for a family member or loved one and how to choose a hospice facility best suited to his or her needs. Beyond knowing the qualifications to be on hospice and finding an appropriate provider, the hospice care costs associated is a consideration. Finding the right program can make all the difference for those who are reaching the end of their life.