A Guide to Medicare
Health insurance, in general, can be confusing if you don’t understand the different components, let alone understanding what all Medicare covers and doesn’t cover. Read on to learn all about Medicare and how this federal health insurance program works.
Who Qualifies for Medicare?
There’s a common misconception that Medicare is only for older people. However, this is untrue. The following individuals all qualify for this federal health insurance option:
- Individuals 65 years of age and older
- Individuals 65 and under with certain disabilities
- Individuals 65 and under with End-Stage Renal Disease (kidney failure)
Now that you know who qualifies, next we’ll discuss the different benefits that Medicare offers. There are two main choices for coverage.
Choice 1, known as Original Medicare, includes:
- Part A is hospital insurance and will cover any hospital stays, home health care and hospice services.
- Part B acts as a medical insurance. This will cover visits to your doctor, lab tests, ambulance services and home medical equipment.
You can also add the following:
- Part D is an optional program that will cover prescription drug costs.
- Medigap. This is a Medicare supplement insurance that will help you pay for out-of-pocket costs when you are enrolled in the Original Medicare plan.
Choice 2 is known as the Medicare Advantage Plan (Part C) and is offered through private insurance companies that contract with Medicare. This choice includes the following parts (same as above):
Important Things to Know about Medicare
Understanding who qualifies and the benefits are two of the most important aspects of Medicare, but there are a few other things you should know too.
- For Medicare, you don’t need to sign up each year after you’ve enrolled, but every year you will have an opportunity to review your coverage.
- Coverage and costs can change yearly, which makes it even more important to review your options every year.
- Both the Original Medicare and the Medicare Advantage generally does not cover any medical care you receive when traveling outside of the United States. With the Original Medicare, supplemental insurance may be available that offers coverage for travel.
- With the Original Medicare, you can visit any doctor that accepts this insurance option. However, with the Medicare Advantage plan, you will need to see a doctor within the plan’s network.
- Original Medicare has no limit on how much you pay out of pocket each year, while Medicare Advantage plans have a yearly limit.
Still Have Questions?
At Progressive Mobility & Medical, we can answer all your questions about Medicare and how it may aid in the purchase of home medical equipment. Give us a call today at 724-228-4568 to set up a consultation or stop in to see us.