Illinois Medicare - How Does Medicare Work

Illinois Medicare programs are publicly funded and administered by the United States government

. These programs provide health insurance coverage to Americans 65 years of age and older. There are several eligibility requirements besides age that must be met for individuals to receive benefits. For people who are generally healthy, the guidelines require that they have been United States citizens or be permanent legal residents for at least five continuous years. Either they or their spouse must have paid Medicare taxes for a minimum of ten years to qualify. There are certain serious medical conditions that allow for early coverage as well.

Medicare is financed in part through payroll taxes and administered through the Department of Health and Human Services. Though the Social Security Administration determines eligibility and processes premiums, the Centers for Medicare and Medicaid Services implements the provisions for insurance reforms. Illinois Medicare programs are available from many providers. The state of Illinois has services and programs available to residents that qualify for Medicare to help them fill the gaps in coverage. Originally there was only Medicare parts A and B. Part A covers inpatient hospital stays of at least one night and brief stays in a skilled nursing facility for recovery from significant medical procedures.

Medicare Part B is for medical insurance. It pays for many services not covered by Part A and is considered optional. Most Illinois Medicare recipients do choose Part B due to its coverage of services and products included in regular private health care plans. These services include X-rays and diagnostic tests as well as blood transfusions, common vaccinations and several outpatient procedures performed at accredited medical facilities. Reimbursements for Part A services use a prospective payments system to allot funds to the proper health care institution. Part B reimbursements are sent directly to the physician.

Due to significant increases in medical expenses and fees, the payments are for a specific amount, based on the treatment received as opposed to the physician's standard rates. Medicare was not created with the intent of providing benefits for all types of medical expenses. As a result, many Illinois Medicare beneficiaries may be unable to pay for products and services that are not covered. The state of Illinois has developed several programs to help these Americans pay for prescriptions, and assistive aids needed to maintain their quality of life while potentially saving thousands of dollars each year. Everyone deserves affordable healthcare.

by: Troy Truman

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