Medicare is the Federal health insurance program for seniors over 65 and the disabled. Original Medicare consists of Part A for Hospital and Part B for Medical. It is NOT free. Part A is funded through payroll deductions that you–or your spouse, paid while working. Beneficiaries who do not have 40 working quarters will be able to buy into Part A by payng a premium. Part B is funded by paying a monthly premium.
Part A--Hospital Insurance, covers care in a skilled nursing facility, home health care, hospice, in addition to inpatient hospital care. Part B--Medical Insurance, addresses doctor's services, outpatient care, diagnostic tests, durable medical equipment, Part B covered drugs, mental health services and more. Except for some Medicare mandated preventive services, cost-shares will apply for most covered medical services. Fortunately, insurance is available to address these needs.
Medicare has been an effective program to promote, treat and maintain the health of beneficiaries. Yet it does not cover everything. Some medical procedures may be deemed experimental and not covered. Services, such as those for chiropractors or acupuncture, may be limited. Additionally, there are no benefits for medical needs such as dental care, eyewear, and hearing aids. Again, Medicare beneficiaries may find insurance plans to handle these needs. Some Medicare eligibles may continue to work and receive care from their commercial plan. Others may qualify for state programs to assist with cost shares. Rules apply. Please check with advisors to ensure eligibility. Group plans may be offered by some organizations to protect their retirees. Usually, with some exceptions, these plans provide terrific benefits that retirees would be wise to take advantage of.
Optional “Parts” have been included in the Medicare program to meet these demands. Medicare Part C refers to Medicare Advantage plans such as HMOs and PPOs. These plans are offered by private insurance companies and are required to meet Medicare standards. Beneficiaries who elect a Medicare Advantage plan will then get their Medicare through that plan. Part D is the Prescription Drug Plan. While optional, beneficiaries are subject to penalties for not enrolling in a Part D plan when first eligible.