subject: Comprehending Your Government Funded Benefits May Sometimes Be A Difficult Task [print this page] Medicare is a beneficial insurance for anyone over 65 years of age. In some instances, coverage is provided for younger individuals who are certified to be disabled. Understanding your Medicare coverage is sometimes daunting. It does not cover every procedure 100%.
Plan A will usually cover a large percentage of your hospital bill if you are treated as an in-patient. It covers a large portion of your doctor's visits as well. Medicare Part B. Will take care of the major portion of out-patient care. It doesn't, however, cover 100% of either.
The Centers for Medicare and Medicaid Services run this government program. It is extremely large. In fact, it is the largest of all health insurance plans in America. It protects forty million people. To be eligible you must be a US citizen, reach the age of 65, have a recognized disability or suffer from end-stage kidney disease. If you require dialysis or need a kidney transplant, you are covered.
The two main Plans are the original Medicare plan and the Medicare Advantage. Each one has sub-categories. Part A is known as the original plan. Each eligible individual is enrolled in this if he or she doesn't select the other plan. Plan C is the alternative option.
Those individuals in the original plan pay a deductible plus a co-pay or co-insurance. Plan C, if you elect to use it, combines the coverage included in both part A and part B. You can also add part D if it is not already included. When you enroll in a Medicare Advantage Plan it will include one of the following: an HMO, PPO, private fee-for-service plan or Medicare special needs plan.
Part A is the hospital insurance provided by Medicare. It covers nursing facility in-patient care, critical access hospitals, hospitals, hospice and certain home health care. Most individuals do not pay any premium for part A. Part B pays for medically necessary services and supplies. It covers outpatient care, physician services, physical or occupational therapists and some home health care. Most people pay a monthly premium for this coverage.
The only coverage provided by plan D is for prescription drugs. Plans vary, but all drugs deemed medically necessary will be covered, sometimes in generic form, sometimes brand-name. A person chooses from several available plans and pays a premium.
Some plans have gaps in coverage. This is the insured's responsibility. He or she can elect to pay those amounts out-of-pocket or pay premiums for a Medigap policy. The Medigap policy is designed to cover those additional costs. If you have no trouble understanding your Medicare coverage, you can select the optimal plan for your health situation. This depends on your current and future (projected) medical care requirements.
