What Is Medicare?

Medicare is a form of health insurance that is offered to people who are sixty-five or older, or to select younger people with disabilities. Offered by the federal government, basic Medicare insurance helps to pay for hospital bills. No matter what plan an individual signs up for, they are automatically enrolled in basic coverage, as they paid taxes to Medicare when they or their spouse were employed. Most people will not have to pay a premium for basic health coverage, though employment will have to. The premium varies depending on how long an individual had been employed through the course of their lifetime. The more someone has worked, the less their premiums tend to be. Basic Medicare covers costs such as: hospital rooms, nursing services, hospice and home care. Basic Medicare is the first of four different plans offered by the government to qualifying individuals.

Supplemental insurance is another plan offered by Medicare to qualified individuals. This plan’s purpose is to cover health care services that are not under basic insurance. Supplemental insurance covers doctors’ services outside the hospital, doctor visits, laboratory tests and X-Rays as well as physical therapy or rehabilitation service, ambulance costs and some medical equipment or supplies when necessary. An individual must sign up for supplemental insurance as well as paying a monthly premium and yearly deductible. These fees are deducted from an individual’s Social Security or SSI check, and the person is responsible for a twenty percent co-pay. The cost of the premium goes up each year, and if someone who qualifies for supplemental insurance does not enroll when they become eligible, they have to permanently pay a higher monthly premium.

A Medicare Advantage Plan covers basic and supplemental coverage, as well as covering medically necessary services. Additional benefits are often offered as well, and may include prescription coverage. Such plans usually have networks, which means that the individual in question might have to see assigned doctors in certain hospitals in order to get care. While a Medicare Advantage Plan can potentially save someone money since out-of-pocket expenses are essentially eliminated, the cost of the plan will vary depending on the services used and the policy that said individual has purchased.

Medicare also offers prescription medication coverage, and everyone enrolled in Medicare is eligible for this service. It may cover most prescriptions and help protect against having to pay higher prices in the future. This policy is actually offered by private companies that work through Medicare. An individual decides which prescription plan they wish to enroll in, and they have to pay a monthly premium. If someone is eligible for this program and decides against enrolling in it when they first become eligible, they may have to pay a penalty should they choose to enroll at a later date.