Medicare is a federal government insurance program for the elderly in the United States. This insurance program is available for citizens over the age of 65 and for those under the age of 65 with either a disability or End Stage Renal Disease. Any US is eligible to receive Medicare benefits, regardless of income, past medical history, or current health status. This insurance program is funded through Social Security and Medicare taxes paid on your income, through premiums that Medicare recipients pay, and partly through the federal budget. Medicare is run by the Centers for Medicaid & Medicare Services, a federal agency.
Types of Medicare
There are two classes of Medicare, Original Medicare and Medicare Advantage. Below is a description of each:
- Original Medicare- This plan is completely paid for by the government and includes Part A (hospital insurance) and Part B (medical insurance). With this plan, most doctors will take your insurance. You will be responsible for cost-sharing such as premiums, deductibles, and co-insurance fees.
- · Medicare Advantage- This plan is provided for by a private insurance company that contracts through the government. The most popular Medicare Advantage plans include Health Maintenance Organizations, Preferred Provider Organizations, or Private Fee-for-Service. This plan is known as Part C and includes the services of Original Medicare at minimum. Most plans provide additional services.
- When choosing the Medicare plan that works best for you, it is important to take into consideration factors such as where you receive medical care, what benefits you would like included (such as vision and dental care), and out-of-pocket costs.
What are the Different Parts of Medicare?
Medicare coverage is provided through four separate parts of the overall Medicare program. Here are the four parts:
PART A
Coverage includes the following inpatient hospital, skill nursing facility, rehabilitation, and home health care services:
- A semi-private room and meals
- Part-time or intermittent skilled nursing care deemed medically necessary
- Physical therapy
- Speech-language pathology
- Occupational therapy
- Hospice benefits for those with a terminal illness and anticipated to live 6 months or less
PART B
Services covered by Part B include doctors’ visits, outpatient care, medical supplies, and preventative care. Here are some examples of these services:
- Flu shots
- Emergency Department visits
- Ambulance services
- Diabetic supplies
- Mammograms
- Diagnostic tests
- Outpatient mental health care
PART C
Part C is provided by private insurance companies and includes at least all of the services provided by Part A and B. Some plans offer additional services such as vision, hearing, and dental coverage.
PART D
This part offers prescription drug coverage. The drug coverage varies depending on the drug plan. Drug plans are provided by commercial insurance companies and other private companies. The government outlines a standard drug plan benefit that must be met or exceeded by each drug plan.
For more information about Medicare, visit the US government website for Medicare here.
If you or a loved one has insurance coverage provided by a Medicare plan and are in search of a caring, quality provider, All-Access Home Health strives to provide our patients and their families with the best care possible. We offer a unique service that helps ensure our patients remain in the best health. If you would like to know more about our services, visit our website or call us at (818) 240-4663 today.
