Medicare is a program of health insurance designed to provide health coverage to people 65 years and over and those with specific disabilities and certain diseases. Medicare is divided into four parts: Part A, Part B, Part C, and Part D. Each element has its benefits and coverage.
1. Part A
Part A Medicare is also known as “hospital insurance,” as it covers inpatient hospital stays that are medically necessary. This includes stays in a hospital, skilled nursing facility, long-term care hospital, inpatient rehabilitation facility, and a psychiatric hospital.
Most people don’t have to pay a premium for Part A coverage if they or their spouse paid Medicare taxes while working. Those who are not eligible for premium-free Part A may be able to purchase it for a monthly premium.
Part A helps pay for the following:
• Inpatient hospital care.
Inpatient hospital care involves being admitted to a hospital as an inpatient. This can include a stay in a hospital, skilled nursing facility, long-term care hospital, inpatient rehabilitation facility, or psychiatric hospital.
• Skilled nursing facility care.
Skilled nursing is provided after you leave the hospital and before you can go home. Skilled nursing facilities offer rehabilitation services, physical therapy treatments, and other medical services that cannot be provided at home.
• Home health care.
Home health care involves skilled medical services and nursing care provided in the patient’s home. This includes a variety of care, physical therapy, speech therapy, and occupational therapy. Home health care is used to help you recover after you leave the hospital or to help you manage chronic illnesses at home before your condition gets worse and requires more intensive treatment. Due to this being a fantastic and popular option for those needing care, there has been a rise in companies such as care for family offering these brilliant services to help those in need.
• Hospice care.
Hospice care is provided if you have a terminal illness and the treatments or interventions used will not cure your condition or prolong your life. Hospice care can be provided in the comfort of your home, in a hospital, or in a skilled nursing facility. Hospice programs offer treatment for symptoms that cannot be controlled with standard therapies.
2. Part B
Part B is also known as “Medical Insurance” and is designed to help pay for certain medically necessary services and supplies not covered by Medicare Part A. With Part B, you can choose from various plans that offer different coverage for the same services.
Part B helps pay for the following:
• Medical services.
This includes medically needed visits to specialists such as dentists and podiatrists. Some of the services that may be covered include eye exams, hearing tests, dental care (with some exceptions), chiropractic care, physical therapy, and personal care services (such as bathing or feeding).
• Home health care
For those who qualify, Medicare can help pay for the home health care provided in your home. The care is provided by a visiting nurse, physical therapist, or other healthcare professionals.
• Medical supplies and equipment.
Medicare Part B helps cover costs for a selection of medical equipment, supplies, and durable medical equipment (meaning equipment that can withstand repeated use), such as oxygen bags, hospital beds, and artificial limbs.
• Blood transfusions and artificial organs.
Medicare Part B helps pay for various medical supplies and services used to help treat or prevent blood loss (such as transfusions) or treat injuries. Medicare also helps pay for artificial organs to replace a damaged or diseased organ, such as a heart, kidney, or liver.
• Durable medical equipment.
Medicare Part B helps pay for a selection of medical equipment, supplies, and durable medical equipment (meaning equipment that can withstand repeated use), such as oxygen bags, hospital beds, and artificial limbs.
Part B does not cover the following services:
• Routine physical checkups.
• Cosmetic surgery (except in certain circumstances).
• Hearing aids.
• Objects that are used to correct physical defects or other conditions that are not health problems themselves.
3. Part C
Medicare Part C, also known as Medicare Advantage, is a health insurance option available to those enrolled in Original Medicare. Medicare Advantage is available in traditional fee-for-service and preferred provider organization (PPO) plans. Medicare Advantage is administered by private insurance companies, known as “provider organizations,” who contract with the federal government to provide coverage. Unlike Medicare Parts, A and B, which are tax-funded, paying for Medicare Advantage is a premium based on the individual’s income. Part B does not cover most Medicare Advantage plans; these services include vision, hearing, and dental care.
4. Part D
Medicare Part D, “Prescription Drug Coverage,” is another part of Medicare. It covers prescription drug costs.
Many people with Medicare plans who want or need prescription drugs may enroll in a Medicare Part D plan instead of paying a separate premium for these services. The plans provide coverage at no extra cost to participants. Prescription drugs include medications used to treat conditions like diabetes, high blood pressure, and asthma and medicines prescribed by doctors covered under Original Medicare (Parts A and B).
Medicare is essential to the United States’ social safety net and significantly impacts state budgets. People with Medicare, their family members, and friends can all benefit from learning more about Medicare, including the Medicare Savings Programs that can result in no out-of-pocket or meager out-of-pocket costs.