Medicare Health Insurance Overview

Medicare is a federal program that provides health insurance coverage to adults aged 65+. However, there are certain circumstances in which a person under 65 can qualify; these circumstances include disability, permanent kidney failure, and Lou Gehrig’s disease. 

Medicare helps stipend the costs of medical treatment. However, it does not cover all medical expenses or long term care. However, you can purchase Medicare Supplement Insurance (also known as Medigap) from most private insurance companies. Medigap will cover the costs that Medicare does not.

What are the Constituent Parts of Medicare?

Medicare has several constituent parts. Parts A and B are federally offered programs, whereas parts C and D must be purchased from private insurance companies, and are not offered through the basic federal program. 

Part A, covers hospital treatment such as overnight stays in hospitals, hospice care, and some health care services. 

Part B provides coverage for doctor visits, the cost of durable medical equipment, home health care, and preventative services like shots.

Formerly known as part C, the Medicare Advantage plan includes all the benefits offered by parts A and B. Additionally, it provides coverage for prescription drugs, and vision, hearing, and dental appointments.

Lastly, part D only provides coverage for prescription drugs. 

Medicare Vs. Medicaid

Medicaid is a state program, and the guidelines for it vary by state. Each state gets to set its own rules and conditions for Medicaid coverage, whereas Medicare is a federal program, with one standard set of guidelines.

Medicaid coverage applies only to the low-income population of each state. Comparatively, Medicare places no qualifying restrictions on a person’s income.

Medicaid only provides coverage for hospital and medical-related issues. Whereas, Medicare, depending on the plan, can cover a variety of health-related needs. 

What Factors Aside From Age Can Qualify a Person for Medicare?

You can qualify for Medicare Part A before you are 65 years old if you:

  • Have Qualified For Social Security Disability Benefits For 24 Consecutive Months
  • Receive Disability Pension From the Railroad Retirement Board
  • Have Lou Gehrigs Disease
  • Are a Child or Widow(er) Aged 50+, of a Government Worker Who Worked Long Enough To Qualify for Social Security Benefits
  • You Have Permanent Kidney Failure
  • You Pay a Monthly Premium for Coverage

If you qualify for Part A, without having to pay the monthly premium, you can enroll in Part B by paying a monthly premium. However, if you pay the premium required to qualify for Part A, you can still purchase part B if you are 65+ and are either a U.S. citizen or a lawfully admitted non-citizen who has lived in the United States for at least five consecutive years. However, you can only enroll in part B at specific times of the year. Failing to enroll in the program the first time you are eligible may result in a late fee.

What is the Difference Between Medicare Plans?

If you receive no-cost Medicare from the government, you are enrolled in Original Medicare. If you purchase your Medicare coverage from a private insurance company you are enrolled in the Medicare Advantage Plan. However, if you have Medicare Plans A and B, then you can join a Medicare Advantage plan. But if you have a Medicare Advantage Plan, you do not qualify for a Medigap policy, as the Advantage plan already includes similar benefits. 

Advantage plans include Health Maintenance Organization plans, Preferred Provider Organization Plans, Private Fee-for-Service Plans, and Special Needs Plans. However, if you sign up for an Advantage plan, you may have to pay a monthly premium, as the advantage plan offers more coverage than the original plan.

Have you been in an accident? Call us now at 801-683-1948 to schedule a no-cost medical exam, a free thirty-minute massage, or a free legal consultation.

Comments are closed.