Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Information on the different programs, eligibility requirements, finding a doctor, and claims or appeals can be found by visiting the Medicare website.
Original Medicare, which is how most participants get their Medicare coverage, is administered directly by the federal government, and has two parts, specifically Part A and Part B. There are also two other Medicare related programs, Part C and Part D that Medicare participants should consider. The four components of Medicare coverage are briefly described below:
Brief descriptions of the different components:
Part A (Hospital Insurance) covers most medically necessary hospital, skilled nursing facility, home health, and hospice care. There are no premiums for this coverage if you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years). You may need to pay a monthly premium if you have worked and paid taxes for less time.
Part B (Medical Insurance) covers most medically necessary doctors’ services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, and certain medical supplies. You pay a monthly premium for this coverage.
Medicare Part C (Medicare Advantage Plans) is a type of Medicare health plan offered by private companies that contract with Medicare to provide you with all of your Part A and Part B benefits and often Part D prescription coverage.
Medicare Part D (outpatient Prescription Drug Insurance) adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans.
Click here for additional information on these programs.
It is important that you enroll in Medicare as soon as you are eligible to avoid increased premiums or penalties. Click here to determine when you need to sign up.
My staff is always available to assist you with issues that you may be experiencing with your Medicare coverage. If you cannot find the answer to your questions through these links or would like my office to contact Medicare on your behalf, please complete my privacy release form and return it to one of my district offices. My staff will be happy to provide you with all possible assistance.