What is Medicare?
Medicare is a Federal health insurance program that pays for hospital and medical care for qualified elderly and disabled Americans. The program has two main parts (A and B) but also offers additional extensions that provide service flexibility and prescription drugs (C and D).
Medicare Part A (Hospital Insurance) – This helps pay for hospital stays, including coverage for meals, supplies, testing and a semi-private room. Home health care or care in a skilled nursing facility may also be covered. Payroll taxes are usually used, so monthly payroll aren’t necessary.
Medicare Part B (Supplemental Medical Insurance) – This requires a monthly premium of $96.40 (as of 2009) and patients must meet an annual deductible of $135.00 before coverage begins. However, it does cover services such as:
• Durable medical equipment (canes, walkers, scooters, wheelchairs, etc.)
• Physician and nursing services
• X-rays, laboratory and diagnostic tests
• Certain vaccinations
• Blood transfusions
• Renal dialysis
• Outpatient hospital procedures
• Some ambulance transportation
• Immunosuppressive drugs after organ transplants
• Chemotherapy
• Certain hormonal treatments
• Prosthetic devices and eyeglasses
Medicare Part C (Medicare Advantage Plans/ Medicare Plus Choice) – This allows users to change their Medicare plan to address specific needs. Medicare Part C may enlist some private health insurance for additional coverage.
However, specific details will vary, depending on what is needed, and if you are eligible for the service or treatment involved.
Medicare Part D (Prescription Drug Plan) – This is usually administered by one of several private insurance companies, each of which offer plans with different costs and provides coverage for different prescription drugs. This expansion also requires a premium and a deductible. Generally, the pricing in these plans mean that 75% of the prescription drug costs will be paid for by Medicare if you spend between $250 and $2,250 in a year. The next $2,850 spent on drugs won’t be covered. However, Medicare will cover 95% of what is spent past $3,600.
Am I Qualified?
To qualify for Medicare, you must be:
• At least 65 years old
• Under 65 and disabled
• Any age with End-Stage Renal Disease
• A U.S. citizen or permanent legal resident for 5 continuous years
• Eligible for Social Security benefits with at least ten years of payments contributed into the system
How do I apply for Medicare?
If you already are receiving Social Security Benefits, you will automatically be enrolled for Medicare Part A and Part B when you turn 65. If your 65th birthday were on August 27, 2010, your automatic enrollment would be on August 01, 2010.
If you are close to 65 and are not yet receiving social security benefits, you may apply for Medicare A and B at the same time. To ensure that your Part B coverage isn’t delayed, you should enroll at least three months before you turn 65, which would be the beginning of your 7-month Initial Enrolment period.
To apply, you may call social security at 1-800-772-1213 or visit your local social security office. To apply online, you may visit http://www.socialsecurity.gov. For more information, please click on this link to be taken to the proper directory.