Medicare Insurance for Seniors and the Disabled
Medicare is a health insurance plan, which has been administered by the U.S. government since 1965. It guarantees insurance for those over 65 and younger people who have certain disabilities and diseases. The concept behind Medicare is that the costs of caring for those who qualify is essentially spread across the entirety of the U.S. working population, as the Medicare tax is levied as a payroll tax, and is used to pay for the Medicare program.
Medicare has four main parts: Part A, Part B and Part D being the most popular, with Part C being less widely utilized.
- Medicare Part A provides coverage for inpatient hospital stays, which are stays of at least one night. This coverage is meant to cover the individual for up to 90 days of hospital stay, with the first 60 days being covered in full, except for a one-time co-pay which covers the first 60-days. The 61st -90th days are charged an additional co-pay. Stays of over 90 days incur additional co-pays, with certain caps which have been predetermined.
- Medicare Part B is meant to cover certain medical procedures and services which are left out of Part A, such as many outpatient services. Doctor visits, x-rays, labs and outpatient services are the most common covered benefits of Part B. Medicare Part B is not mandatory. However, certain rules apply for not accepting Part B, and a penalty may apply if it is initially not accepted and you decide to enroll layer.
- Medicare Part C is also known as Medicare Advantage plans. Part C includes Parts A and B and usually Part D, prescriptions drugs. Medicare Advantage plans replace original Medicare and are replaced by private health insurance companies that assume the risk of your medical expenses. These plans must cover at least what original Medicare covers. These plans allow you to not only have prescription drug coverage, but, may also offer coverage for dental and vision expenses. Some of these plans have very low monthly premiums, making them very attractive. With that lower premium, however, usually comes a larger out of pocket exposure if you get sick. Heidi Olsen Insurance will help you understand the advantages and disadvantages so you can make your most informed decision.
- Medicare Part D is specifically for prescription drug coverage; however there are several options which cover different drugs or classes of drugs. If you become eligible for Part D, but choose not to enroll, there will be a penalty you must pay should you decide to enroll later. The penalty is calculated based on a formula, and may differ for different people. The penalty is assessed if you go more than 62 consecutive days, from your initial enrollment, without Medicare Part D coverage.
While Medicare covers around 80% of covered medical expenses, about 20% is left for you to pay. There are many Medicare Supplemental or Medigap plans available to cover this 20% of medical expenses that you are responsible for, including some Medicare Advantage plans.
Give Heidi Olsen Insurance a call today to help you find the plan that is right for you and your situation.