Healthcare

What Is Covered By Medicare? 

What Is Covered By Medicare? 
Written by Guest Author

Medicare is a federal health insurance program that provides healthcare coverage for 65 and younger individuals with disabilities. Medicare is funded by payroll taxes paid by employees, employers, and government agencies.

Medicare covers hospital care, doctors’ visits, outpatient visits, prescription drugs, and other medical services. It also covers preventive health services such as vaccinations and screening tests. These benefits are available even if you have private health insurance or no insurance at all. If you live in the US, every resident has access to Medicare and most other public medical insurance plans.

Who Is Covered? 

Medicare is available to people 65 years of age or older and younger people with disabilities. People over 65 can enroll in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance), while People with disabilities can enroll in Medicare Part A only. 

Medicare is financed through payroll taxes. To be eligible for Medicare benefits, you must pay payroll taxes. Your payroll tax depends on the amount of money you earn and whether you are a high-income earner.

What is Part A, Hospital Insurance? 

Part A provides hospital insurance for people 65 years of age or older and younger people with disabilities. It covers 100% of the Medicare-approved cost for inpatient hospital services (excluding the first 60 days). Outpatient health care services covered under Part A include doctor’s office visits, outpatient surgery, and some medical equipment. Part A does not cover dental care. The benefit does not apply if you have private health insurance that covers these services.

What is Part B, Medical Insurance? 

Part B provides medical insurance for 65 years. It covers 100% of the Medicare-approved cost for doctor’s office visits, outpatient surgery, and medical equipment. Part B does not cover dental care.

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What is Part C, Prescription Drug Coverage? 

Part C provides prescription drug coverage for 65 years of age or older and younger people with disabilities. Medicare beneficiaries may buy a private plan from an insurance company or use the Medicare Advantage government plan, a managed personal insurance program. Under Part C, each individual receives their own Medicare card that can be used to fill prescriptions at any pharmacy. The card will not be mailed to you; you must pick up your card when you receive your first prescription drug benefit card in the mail (usually about two months after enrolling in Part C).

Does Medicare Require A Referral To See A Specialist

If you’re enrolled in the government’s Original Medicare, you don’t need a referral to see a specialist. Original Medicare usually allows you to see any doctor you want, but the doctor has to accept Medicare payments.

How Much Does Part B Cost? 

The Medicare-approved amount for each doctor’s visit is $35; the Medicare-approved amount for outpatient surgery is $310; and the Medicare-approved amount for medical equipment, such as wheelchairs and walkers, is $1,080. You may also have to pay a deductible of up to $100. The total cost can be higher than this because you may have to pay coinsurance (a percentage of the Medicare-approved amount) or copayments (a fixed dollar amount) when you go to doctors’ offices or outpatient surgery centers. If you are eligible for premium assistance, the total cost will be lower than the above amounts. There are also other costs, such as a deductible for Medicare Part D.

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What Is Part B? 

Part B is the part of Medicare that pays for doctors’ visits, outpatient medical services, and some hospital stays. You are responsible for paying a monthly premium to keep Part B going. If you are 65 or older and have paid Medicare taxes or dividends for at least 40 quarters (10 years), you will be eligible for Medicare Part A, the hospital insurance part of the program. If you are 62 or younger, you will be eligible to enroll in Part B. You may also be able to get health coverage through your state’s Medicaid program if your income is low enough (or if you qualify under certain circumstances).

What Is Part D? 

Part D is the prescription drug program. It is available to people with Medicare Part A, Part B, and anyone who is eligible for Medicaid. Most people pay a monthly premium to keep Part D going. If you are 65 or older and have paid Medicare taxes or dividends for at least 40 quarters (10 years), you will be eligible for Medicare Part A, the hospital insurance part of the program. If you are 62 or younger, you will be eligible to enroll in Part D. You may also get health coverage through your state’s Medicaid program if your income is low enough (or if you qualify under certain circumstances).

How Do You Enroll In Medicare? 

To enroll in Medicare, you’ll need to go to your local Social Security office and file an application. If you are eligible, they will process your application and send it to the Centers for Medicare & Medicaid Services (CMS) for approval. Once approved, you will receive a notice from CMS that includes information on how to get medical coverage under Medicare. The notification will also have an identification card with a bar code. You will use this bar code when you sign up for health insurance through Medicare or any other Medicare-approved plan.

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When Can You Start Receiving Benefits? 

At 65, you can enroll in Medicare and begin receiving benefits. 

To qualify for Medicare, you must be a US citizen or permanent resident.

You cannot receive benefits if you are not a US citizen or permanent resident.

Conclusion

It is important to note that the Medicare system is designed to protect people from financial hardship when they can no longer work. While we live in a free country, it is still crucial for us to understand how our government works and what we can expect from the various programs in place to make educated decisions about our future.

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