Medicare was officially established in 1965 by then President Lyndon B. Johnson. Its parent program was created to provide medical benefits and services to the spouses and families of active U.S. military personnel. The Dependents’ Care Act (DCA) as initially named was passed into law in the year 1956. Between the DCA and the establishment of Medicare via the Social Security Act Amendments, President Dwight D. Eisenhower held the White House Conference on Aging in 1961, serving as a further catalyst to the imminent formation of Medicare. Medicare has a deep history, but who is Medicare for in modern American society?
Medicare is a type of medical insurance provided by the federal government for people ages 65 and over or with physical, mental or other qualifying disabilities. People with Medicare coverage either cannot pay for medical expenses themselves due to a limiting disability, or, are senior citizens eligible due to their age. The concept is simple at the fundamental level but coverage terminology is complicated for many to fully understand.
There are four parts to Medicare coverages. These parts, A through D, cover different services through various medical providers. Each part also has nuances to its coverage terms and terminology. There are also extended branches of Medicare to be discussed. Read on to discover everything you should know about Medicare insurance.
How Does Medicare Benefit Seniors?
The Medicare program benefits seniors by providing medical coverage during retirement years, when many people 65+ are at higher risk for illness, injury and accidents. It is part of the U.S. Social Security Administration (SSA), which provides various additional benefits of to qualified Americans. The various parts of Medicare provide different types of coverage including prescription medication plans.
Medicare Part A
Medicare Part A covers admissions and stays in hospitals, hospice care facilities and some nursing centers. It also covers a limited amount of home health care services. Home health care involves nurses and/or other medical practitioners visiting your home to provide services. Medicare Part A is free to most people who paid, or whose spouse paid, applicable taxes during working years. Those who do not qualify for free Medicare Part A benefits can purchase them for $252 to $458 per month. For more information on Medicare Part A, its costs and coverages, go HERE.
Medicare Part B
Medicare Part B is a type of health insurance covering non-inpatient medical services. These outpatient services include follow-up doctor visits, visits from doctors while admitted to a hospital, annual checkups/physicals and preventative treatment services. They also include medical supplies such as surgical braces, walkers, oxygen tanks and more.
Medicare Part B is a crucial coverage plan for people with more serious issues or diseases. For example, expensive dialysis for the kidneys, chemotherapy and other cancer treatments are covered under Part B. Adjusted gross income, your applicable tax bracket and tax filings affect the amount paid each month to maintain Part B coverage. Applicable costs of Medicare Part B are also based on the following:
Policies as decided by Medicare on a national basis.
Individual Medicare providers deciding whether a procedure, visit or item is medically necessary.
State and federal laws
Medicare Part C
Medicare Part C plans offer alternate ways to receive medical coverage through Medicare. Also known as “Medicare Advantage,” Part C plans are frequently outsourced to privately run insurance companies bound to follow Medicare rules, albeit with nuances to some out-of-pocket charges and covered services. Medicare Part C sometimes also includes prescription benefits. Qualifying for Part C requires already being enrolled in Parts A and B. Out-of-pocket costs of Part C varies per state and provider.
Medicare Part D
Medicare Part D covers prescription medications. Part D was added to Medicare in 2006 as a means of protecting those enrolled in Medicare from soaring prescription drug prices. Minimal copays can still be expected. The cost to Part D enrollees varies per state and income. There is also a late-enrollment penalty applied if Part D is not accepted when initially available.
Medicare Open Enrollment 10/15/20 – 12/7/20
What is Medicare open enrollment? It is an opportunity for current enrollees to adjust their coverage plans and/or providers to better suit their needs. Current enrollees are not required to make changes to their plans during this period, but plan/provider evaluation is encouraged.
Changes made to your plan during open enrollment periods go into effect on the first day of the subsequent month following receipt of your submission of requested changes. This means, for example, changes made between 10/15/20 and 10/31/20 will go into effect on 11/1/20, provided Medicare received your requests in time to accommodate. Changes can include adding or removing Plan D and changing the type of Medicare coverage you receive.
Medigap, also referred to as “Medical Supplemental Insurance,” is a service provided by independent and private insurance companies. While Medicare covers most services and expenses, having Medigap is a viable way to guarantee full financial and medical coverage. Medigap covers deductibles, copayments and coinsurance not covered by your Medicare plan.