What Is Medicare? A Break Down Of Coverage
Medicare is a federal insurance program that covers medical expense for people 65 and older, which is the enrollment age. There are some ways, however, to obtain this insurance if you are younger than 65. The coverage itself can be a confusing maze of providers, prescriptions, and paperwork. We’ll take a look at the coverage elements as well as the qualifying factors.
What Does It Cover?
- Medicare Part A: Hospital insurance that covers necessary hospital visits and stays, home health, and hospice care. If you have worked and paid Social Security taxes for at least 10 years, this benefit is free. You’ll pay a monthly premium if you haven’t worked and paid taxes for at least a decade.
- Medicare Part B: Medical insurance that covers preventative care, doctor’s visits, necessary medical equipment, outpatient services, lab work and x-rays, ambulance service, mental health treatment, and some home health services. You’ll pay a monthly premium for this coverage.
- Medicare Part C: Policy from a private insurance company that offers Medicare benefits. These private health plans – like HMOs and PPOs – are called Medicare Advantage Plans. You can opt for this plan instead of original Medicare.
- Medicare Part D: Outpatient Prescription Drug Insurance covers outpatient prescription drug needs. Part D is not provided directly from the government; it can only be obtained through a private insurance company that has a contract with the government. You can only get Part D coverage that works with your other benefits. Part D is typically offered as part of a Medicare Advantage
Am I Eligible For Medicare If I am Under 65?
If you’ve received Social Security Disability Insurance, or SSDI, for more than two years, you will receive Medicare benefits. At the beginning of month 25 that you receive a SSDI check, you’ll be automatically enrolled into the program.
The exception to the 24-month waiting period is if you receive SSDI because you are diagnosed with Amyotrophic Lateral Sclerosis (ALS). For ALS patients, Medicare begins the first month you receive SSDI.
Another circumstance that may allow you to obtain this insurance if you’re not 65 is if you’ve been diagnosed with End-Stage Renal Disease, also known as ESRD or kidney failure. If you’ve had a kidney transplant or receive dialysis treatment, you may be covered.
What’s The Difference Between Medicare And Medicaid?
Medicare is not the same as Medicaid. While both programs are run by the government, they each serve a different group of people. Medicare is a federal health care program designed for those usually 65 and older, no matter the person’s income. Medicaid is an income based state and federal health care program, typically reserved for low income individuals or families.
Primary Care Physicians Near Me
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