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Medicare is federally-funded health insurance for people who are 65 or older. In some cases, people may qualify for Medicare if they are younger and have End-Stage Renal Disease. In order to qualify for Medicare you must be either a U.S. citizen or have worked at least 40 quarters, or 10 years, at a job that contributed to your Medicare. All of your healthcare needs are broken down into different plans which they are serviced through. When you have coverage for all parts, then you have comprehensive coverage that allows you to receive preventative care, but also emergency care when you need it.
Here are the parts explained
Medicare Part A
This hospital insurance covers inpatient care at hospitals, skilled nursing facilities, hospices and home health care, in some cases. It also includes surgeries and lab tests done in the hospital. If you have a Medicare Advantage Plan, then it can be used to cover additional costs if you exceed the maximum amount of time that Medicare will pay for your hospital visit (more on Medicare Plan C will be discussed later). Patients are always advised to check that their preferred hospital is within the plan they choose.
Your eligibility for Medicare Part A starts 3 months before your 65th birthday. Your enrollment window closes 3 months after your 65th birthday. You only have that 6-month window to sign up for Medicare, even if you do not want to receive retirement benefits yet. A Medicare specialist can explain more to you if you getting ready to enroll, or are afraid you missed your enrollment period.
Medicare Part B
Plan B, in contrast to Plan A, is your medical insurance that covers outpatient care. The two types of services that Part B covers include medically-necessary services and preventative services. Medically-necessary services are services or supplies that are vital to treating or diagnosing a medical condition, and are considered standard, acceptable medical practices by professional boards. Preventive services include preventing illnesses, such as the flu, or being able to detect conditions in an early stage. The different types of services that you can use your Part B to cover include:
- Doctor visits
- Lab tests
- Durable medical equipment
- Clinical research mental health services including inpatient, outpatient and partial hospitalization
Medicare Part C
Medicare Part A and Part B cover a lot of services, but they do not cover everything. There may be gaps in your coverage that you will be financially responsible for. If you are retired or have significant health concerns, then you may be interested in saving money by supplementing your Medicare insurance with another plan that covers the gaps in your Parts A and B. Medicare Advantage Plans, also known as Medigap plans, are provided through private insurers to meet this need. And the good thing about a Medicare Advantage Plan is that you cannot be denied coverage if you develop a condition later, or if your health worsens due to age.
Medicare Part D
Medicare Part D covers your prescription drugs and allows you to purchase them with an affordable co-pay. The Medicare Part D program is a federal program that began in 2006. Like Medicare Advantage Plans, Medicare Part D is provided through private insurers in each state. The monthly premiums vary depending on where you live, but in 2020 the national average premium was $30 a month.