Implemented in the year 1966 by the US government as part of the Social Security Act, Medicare is a national health insurance program that takes care of the medical needs of older Americans.
Today, Medicare programs serves about 39 million people and strives to make sure Americans get the health care and prescription coverage they need and deserve, like regular health check-ups, hospital stays, and drugs.
Medicare Eligibility and Enrollment
Medicare Program is not based on financial need because like Social Security, it is an entitlement program. Since the federal government runs Medicare, the eligibility criteria are constant throughout the US. Also, the coverage does not change regardless of where you get treated in the US.
The initial enrollment period is 7 months, stretching from 3 months before your 65th birthday till 3 months after that day. If you want to sign up after this, you will have to pay enrollment fees and penalties as specified in the Medicare program. So, timely enrollment in Medicare is critical. However, there is also a special enrollment period from January 1 to March 31 every year during which you can buy Medicare.
You qualify for the Medicare programs if you are
- 65 years or older OR
- Under age 65 with specific disabilities OR
- Any age with terminal-stage renal disease.
The Department of Health and Human Services has divided Medicare benefits into four parts – Part A, Part B, Part C, and Part D as under :
Medicare Part A
Medicare Part A (Hospital Insurance) covers a portion of in-patient care in hospitals, skilled nursing facility, hospice, and home health care (if you meet certain conditions).
Medicare Part B
Medicare Part B (Medical Insurance) covers a portion of medically-necessary services such as doctors’ services and outpatient care. Part B also covers a portion of preventive services to help maintain your health and to keep certain illnesses from getting worse.
Medicare Part C
Medicare Part C (Medicare Advantage Plans) are managed by private insurance companies approved by Medicare. Part C combines Part A, Part B, and, sometimes, Part D (prescription drug coverage). These plans must cover medically-necessary services. However, plans can charge different co-payments, co-insurance premiums, or deductibles for these services than those charged by the government in Medicare Parts A and B.
Medicare Part D
Medicare Part D (Medicare Prescription Drug Coverage)covers a portion of your prescription drug costs. This coverage may help lower your prescription drug costs and help protect against higher costs in the future. Individual plans vary greatly in cost and specific benefits; you should use one of the online tools to evaluate your particular costs and needs.