Understanding Medicare: Why Do You Need It?

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Health is wealth, but it can be expensive for some families, especially if you need special needs. Fortunately, the U.S. government has launched an insurance program to ease the financial issues of people who need significant medical attention. However, it can be a bit difficult to hover around this program if you don’t know what you’re looking for.

To get you started, here is what you need to know to help you learn more about this program.

What is Medicare?

Medicare is a health insurance program by the government to help senior people and other eligible younger people with disabilities. This program is available in the United States. Like regular insurance, Medicare offers various plans that will suit your family, covering different healthcare aspects.

To further understand why you need Medicare, here are a few advantages you can get in the program:

  • Wide Range of Coverage. The government has been trying to improve Medicare’s coverage, and many medical companies have participated in enhancing the program. Since its inception, Medicare has already helped a lot of aging adults and younger citizens with special needs.
  • More Affordable Premium. Since Medicare aims to help people with special needs, many enrollees have qualified for the premium-free Part A plan of the program. However, they’ll only need to pay a small out-of-pocket monthly for Part B.
  • Improved Medical Standard. Since the program’s introduction, Congress has now enhanced the standards for hospitals that aim to enroll in Medicare programs. So, Medicare enrollees can be at ease that eligible hospitals are top-notch and have passed the quality standards of Congress.

What Are the Different Plans of Medicare?

One thing to expect about the Medicare program is that it continues to improve every year to keep on providing efficient plans to its enrollees. So, you can look forward to a good selection of plans that you can choose from once you become eligible for this program. To help you, here’s a brief introduction to the plans the program offers.

Original Medicare

The original Medicare is automatically offered to the enrollees who become eligible for the Part A and Part B of the program. If you have the Original Medicare plan, the government directly covers the health care services you receive. Moreover, Original Medicare includes the following:

  • Part A (Inpatient/Hospital Coverage). Eligible enrollees automatically get Part A for free. However, some people don’t qualify for the premium-free Part A and may have to pay for the coverage or buy it. An eligible enrollee can receive inpatient care in the hospital, hospice care, nursing home care, skilled nursing facility care, and various home health care services.
  • Part B (Outpatient/Medical Coverage). Enrollees must pay a premium for Part B coverage, even if they don’t get its services. The monthly premium is automatically deducted from your income. Moreover, this plan covers two types of services: preventive and medically necessary, including ambulance services, mental health-related services, clinical research, and limited coverage of prescription drugs.

Medicare Advantage Plan

The Part C of Medicare is also known as the Medicare Advantage Plan, an entirely different type of Medicare you can enjoy. The difference between Medicare Advantage Plan, the Original Medicare, is that the former is a type of private insurance offered by partner companies of the Medicare program.

You can enjoy private health plans like PPOs and HMOs by getting your Medicare coverage through a Medicare Advantage Plan. People usually get their health coverage from Original Medicare and then choose their benefits from the Medicare Advantage Plan.

You’ll still enjoy the benefits offered by the Original Medicare, but the Medicare Advantage Plan may set different rules, restrictions, and costs, generally affecting how you’ll receive care.

Aside from Part C, the Medicare Advantage Plan includes Part D, the Prescription Drug Plan.

  • Part D (Prescription Drug Plan). This plan is not automatically offered to the enrollees. To get Part D coverage, you must get the private Medicare Prescription Drug Plan (PDP) or the Medicare Advantage Plan with Drug Coverage (MAPD) yourself. As the name suggests, you can enjoy discounted prices of your prescriptions if you get this plan, but you should also still consider your circumstances when getting one.

How Do You Use Medicare?

If you’re wondering how to utilize Medicare for your hospital admission, doctor’s visit, or prescription drugs, you’ll only need to visit a doctor or hospital that takes this program. However, you must be lawfully present in the U.S. so that the federal government will pay your Part A and Part B claims and have a chance to enroll in other Medicare plans.

On the other hand, if you’re wondering if there is a Medicare for massage therapy, counseling, physical therapy session, and other non-regular hospital services, you should consider reaching out to an expert Medicare counselor or call contact the Medicare Rights Center to discuss your coverage.

Final Thoughts

It will help if you take every opportunity and assistance to ease your financial burden. As such, you can live a better life free of worries. Fortunately, the government is making an effort to help its citizens. If you feel eligible or want to know if you’re eligible, don’t miss a moment and contact them as soon as you can.


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