Insurance can be pretty confusing, especially when it comes time to select the plan that best suits your needs. As you age, you will want to think about applying for Medicare, alongside any other insurance plans that you’ve signed up for, which can add another layer to this confusion. We know that Medicare is a benefit that comes with age, but what exactly is it?
What Exactly is Medicare?
Medicare is a government-based health insurance program initially created in the 1960s for people as they enter retirement. To qualify, applicants must be 65 or older and have paid taxes for a specified amount of time. If the applicant hasn’t paid the specified amount in taxes, they still qualify but may come across increased premiums and deductibles. The idea that Medicare is just for the elderly isn’t entirely true either. People with debilitating and potentially deadly illnesses like MS can apply for Medicare as well.
The Medicare program is split into four parts, with parts A and B as the default Medicare options. Each part covers different areas of healthcare, and applicants are able to pick and choose which parts they need.
Medicare Part A
Medicare Part A covers the hospital portion of healthcare. Inpatient hospital services and hospice care are covered, as are nursing homes, skilled nursing care outside of a hospital, and home-based health care. The care listed in part A is not all necessarily long-term either. Skilled nursing care and inpatient care are short term and must be given a specified end date when needed. This part of Medicare is great for people who visit the hospital frequently or are in assisted living facilities. This part of Medicare comes without premiums as well.
Medicare Part B
Medicare Part B covers alternate care methods. This includes clinical research, ambulance services, and durable medical equipment. Part B also covers mental health services such as inpatient and outpatient hospital care, partial hospitalization services, and some prescription drugs. This is great for people with mental health conditions like depression, anxiety, and post-traumatic stress disorder since mental health services are covered for at-risk patients alongside clinical trials which can help diagnose both mental and physical illnesses as they arise.
This part of Medicare comes with a premium based on household income and prior tax payments.
Medicare Part D
Part D in the Medicare family covers prescription drugs. This includes mental health drugs, painkillers, and any other medication prescribed to a patient by their doctor. Typically, doctors will take their patient’s insurance into account when prescribing drugs to help make them more affordable, and for reference, there is a list of covered drugs on Medicare’s website as well.
For policyholders with any questions regarding prescription drug coverage, be sure to consult your doctor, pharmacist, or Medicare provider.
Medicare Part C
Although it is technically included “before” Part D, Medicare Part C is supplied by private insurance companies. Often called “Medicare Advantage Plans”, this section covers what both parts A and B cover. Since it is through a private insurance company, however, policyholders of Medicare part C may need to pay extra premiums or deductibles. Part C works like a secondary insurance plan, which can step in when base Medicare may not be able to cover all of a bill. Because it is not affiliated with the government, Medicare Advantage Plans are also structured like the typical insurance policy: policyholders will need to see affiliated doctors and specialists in order to receive coverage. In some cases, Part C also covers prescription drugs, but that is at the provider’s discretion.
The final part of Medicare comes in the form of Medicare Supplements. A Medicare Supplement, much like Part C, is a type of additional insurance policyholders can add to their Medicare plan. Supplements cover gaps in Part A and B’s coverage, at the potential cost of a higher premium. Also known as “Medigap”, this policy covers a wider variety of prescription drugs, potential emergencies when traveling, extra deductibles, copays, or coinsurance. While this policy does not cover every gap in Medicare Parts A and B, it does extend coverage to include a wider variety of situations.
As always, ask your doctor or your insurance provider if you have any questions regarding your insurance plan. If you are looking to purchase medical supplies via Medicare directly to your home, visit Medical Supply Depot.