Healthy Living / Lifestyle

The Basics of Medicare

basics of medicare

Medicare is a federal social insurance program that helps certain groups of people pay for their healthcare services. The ones covered in the plan include people who are above 65 years of age, people living with disabilities, and those with End-Stage Renal Disease.

Parts of Medicare

Medicare has different parts aimed at catering for particular health services. The different parts include:

  • Part A (Hospital Insurance)
  • Part B (Medical Insurance)
  • Part C (Flexible Insurance)
  • Part D (Drug Prescription)

How Medicare works

Medicare Part A

Part A is a hospital insurance plan that helps patients cover inpatient services, services in a skilled nursing facility, hospice, and home healthcare services like physical, occupational, and speech therapy. It is pr

You don’t qualify for this plan if you haven’t paid Medicare taxes for at least 40 quarters. You’re free to pay monthly for part A if you don’t qualify for premium-free Part A. You’ll pay $499 each month if you’ve paid Medicare tax less than 30 quarters and $274 if you’ve paid for 30-39 quarters to subscribe for Part A.

Medicare Part B

Part B covers specific doctors’ services, office-based medical supplies, injectable drugs, preventive services, home healthcare, elderly and disabled services, and outpatient services and it might cover a caregiver service.

There is a standard Part B premium amount to be paid. An extra charge is added to the premium, considering your earnings.

For Part B, the standard monthly premium amount is $170.10, and one must meet an annual deductible a year before the plan pays for treatment.

Medicare Part C

SS and medMedicare Part C, also known as Medicare Advantage, is an approved plan to offer patients with customized services to address their specific health situations according this page. The plan provides all the services in Part A and B with other extra benefits like dental, optic, or hearing services.

Private companies approve the plans to offer alternative health coverage. The plan must, however, follow coverage rules as they have annual contracts. They will hence depend on the program and the suitability of the individual.

There are Medicare Part C Plans that offer preventive or specialized health services in collaboration with health maintenance organizations (HMOs) or preferred provider organizations (PPOs), while other plans focus on people living with disabilities.

Health Maintenance Organizations (HMOs) help patients get care in specific hospitals and doctors, while PPOs allow patients to get care from outside providers at a higher cost. This Part D plan also offers waivers for members in group health coverage through employers or unions.

Medicare Part D

Medicare Part D, also known as Medicare prescription drug coverage, was initiated to help pay for different lists of drugs. Each plan has specific drugs even though there is standard coverage for all. To get this coverage, you must have a Medicare-approved plan, including Medicare drug plans and Medicare Advantage Plans with drugs.

Different monthly premiums are paid for this plan. The plan you settle on will determine the amount you pay. You have to pay another additional fee called Part D income-related monthly adjustment amount. This fee is determined by the amount of money you earn.

You can either get a bill directly from Medicare every month or have the premium automatically deducted from Social Security checks. Most of the Medicare funding comes from payroll taxes and self-contributions. Employers contribute half of the tax while the employee pays the other half. Other funding is from premiums, deductibles, copayments, and coinsurance.

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