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What is Medicare?
Medicare as health insurance is applicable to all the American whose age is 65 above along with people suffering through certain conditions. The idea of Medicare was first coined back in 1965 by the federal health insurance program. It is one of the most prominent programs to provide benefits to all the senior citizens, along with all the disabled persons going through end-stage illness.
As of today, there are two types of Medicare people can find out there in the market. The first one is often termed as Original Medicare, which is managed by the federal government while the other goes by the name of Medical Advantage. This particular Medicare program is provided by private insurers that cover the same benefits of Original Medicare, along with some additional coverage.
One of the biggest differences between Medicare and regular health insurance is that with Medicare, one can avail of treatment from any doctor, facility, or hospital that is registered in the Medicare program. There is no need for any approval from the primary physician or specialist. Bear in mind; there is no coverage for the majority of the prescriptions when it comes to the Original Medicare. So, under such circumstances, it is better to look for better alternatives.
Understanding the Difference Between Medicare and Medicaid
There are several instances where a person might be qualified for both Medicare and Medicaid. Medicaid comes under the health insurance program, which is specially curated for children, low-income adults, pregnant women as well as disabled. Medicaid programs generally run by the joint effort of the state and the federal government. Based on the guidelines set forward by the federal government, local governments act according to the same. Based on income and assets, the state government determines eligibility for the Medicaid program.
There is a wide variety of medical insurance coverage that comes under the Medicaid program. These include lab tests, visit the doctor, hospital expenses, stays in the nursing home as well as numerous healthcare services. The Medicare savings account is also overseen by Medicaid. This ensures that you are able to pay all the expenses that are not covered in the Medicaid program. Bear in mind that there is coverage for long term stays in the nursing home and at-home care, but that is not applicable for long-term care facilities.
What Does Medicare Covers?
Based on the type of Medicare you choose, the coverage varies. Here we have properly curated the four major types of Medicare based on different needs and coverage.
Medicare Part A
Basically, Medicare Part A is hospital insurance. Inpatient care in the hospital, nursing home, and even home care is covered by Medicare Part A. The deductible for Medicare Part A is set to be $1316. That means the recipient needs to pay that amount upfront in order to avail of the benefits of Medicare coverage.
While Medicare Part A is not completely free, there is no hassle of paying the premiums. There are instances where you may not be eligible for the premium-free Medicare Part A. Our recommendation goes to buying Medicare Part A and Medicare Part B altogether. This helps to bring down the overall most for Part B premium.
Medicare Part B
Medicare B is, by far, one of the most comprehensive medical insurance. It covers all the doctor’s services, medical supplies, outpatient care, and even preventive services. One hidden perk includes paying the late enrollment penalty fee if you don’t sign up for Medicare Part B in the given time frame. At the same time, there are also some instances where people can Medicare Part B automatically.
Medicare Part C
Medicare Part C is also termed as Medicare Advantage Coverage. It provides all the same benefits that you can reap from any standard Medicare. The only perk is that it goes through the chain of private insurer networks. The monthly premium for Part C is set lower than the regular premium. But, that doesn’t mean Part C can completely replace Medicare Part A and B. There is also an out of the pocket limit for Medicare Advantage.
Medicare Part D
Medicare Part D includes prescription drug plans. This generally varies from $16-$17 per month to all the way up to $71. The deductible for Medicare Part D remains at $400. Bear in mind that the overall cost of the premium completely depends upon the overall income as well as the selected plan.
Does Medicare Covers Assisted Living?
No, Medicare won’t be covering for assisted living. That includes the overall cost of the room, along with all the personal rooms. On the contrary, you can actually get Medicare Advantage, which can actually cover the expenditure for personal care assistance along with all the supportive services that go into assisted living. Generally, the cost of assisted living ranges from $2000 to $6000 per month. Since Medicare won’t pay for the same, you can get certain coverage from Medicare Advantage. Some of the costs can also be paid through Medicaid.
Does Medicare Covers for Hearing Aids and Dental?
Original Medicare doesn’t cover for either of them. But, depending on the plan you choose, Medicare Plan C can actually provide coverage for hearing aids. Similarly, whether it be dental care, procedures, fillings, or even cleaning, you need to pay 100% for them. Now, there are some Medigap, which actually provides dental coverage, but you need to show accordingly.
How Does Medicare Works?
Enrolling for Medicare is possible even when someone is not retiring any time soon. You can easily compare Medicare rates in order to have a better understanding of what works best for you. Make sure to have a comparison of the cost as well as the benefits, including dental and vision. Sometimes a Medicare with a supplementary plan including Medicare Advantage can be the most cost-effective option.
Qualification for Medicare
Any citizen from the United States or someone who has a permanent residency for at least five years is eligible for getting the benefits of Medicare. The initial enrollment begins three months prior to the 65th birthday while ending three months after that. The eligibility criterion also includes if you or your spouse is a retired government employee paying for the Medicare taxes.
People under the age of 65 are also eligible for Medicare if diagnosed with permanent disabilities or been benefitted over the past two years. People diagnosed with ESRD (end-stage renal disease) or ALS (Lou Gehrig’s disease) are also applicable to Medicare.
Signing Up for Medicare
We offer a plethora of comprehensive plans to choose from when it comes to Medicare. You can also compare Medicare Advantage Plans based on your needs for dental, vision, or even hearing. Our entire walkthrough process can easily guide you through signing up for Medicare with ease. So that you can just sit back and relax.
How Much Medicare Costs?
There is no scope for deductibles when it comes to Medicare. A person needs to pay the set amount even before Medicare starts paying for the coverage. After the coverage starts, there is still the need for paying a certain amount of coinsurance. This, in turn, will cover all the supplies and services. The only upside is that there is no out of the pocket expenses on an annual basis. As for Medicare Part B, you can also opt for a monthly premium.
There are several factors that go into determining the out of the pocket expenses. The best course of action is to opt for both Part A and Part B Medicare. Without the financial backing from both, you might be paying more on the supplies and services. The cost of the overall premium also depends on some of the factors such as health, along with the type of intensive care you will be needing. For all the supplies and services that don’t come under Medicare, you are solely responsible for the expenses. The overall cost also depends on whether you have other health insurance or not. One fine example is Medigap, which is the Medicare Supplement Insurance.
Certainly, one form of Medicare costs more than the other. For example, you don’t have to pay the same premium in Medicare Part A as that of Medicare Part B. But, oftentimes, Medicare Part A comes with certain deductibles. The last revised deductible back in 2017 was $1316. That means you need to pay the amount while the rest is covered by Medicare.
Premium-based Medicare includes Part B, C, and D. The monthly estimate of Part B is about $135 with a deductible of $183 per year. For the majority of the times, the recipient needs to pay almost 20% of the Medicare-approved costs.
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