Medicare

Medicare for seniors is a special health insurance plan run by the federal government to help Americans over the age of 65 with the high costs of healthcare. Medicare is the largest health insurance service in the nation, and you must be a United States citizen to qualify. You must also have paid taxes into the Medicare system for a minimum of ten years; in most cases these were automatically deducted from your paycheck. You may also qualify for senior Medicare if you have certain disabilities or end-stage kidney disease requiring a kidney transplant or dialysis

There are two main categories of Medicare for senior citizens: the Original Medicare plan and the Medicare Advantage plan. The key component of the Original Medicare plan is Part A. This is a type of hospital insurance that covers inpatient care in the hospital, a skilled nursing facility after a hospital stay, some home healthcare services such as skilled nursing care, and hospice care for those who are terminally ill with six months or less to live. You will be automatically enrolled in Medicare Plan A unless to chose to join the Medicare Advantage Plan. Plan A has no premium.

Medicare Part B offers medical insurance that can help pay for services not covered by Part A, such as doctor’s visits, outpatient hospital care, and some physical or occupational therapies. Part B also covers things such as lab tests and services, and preventive services including flu shots, glaucoma tests, colorectal cancer screenings, and diabetes screenings and management. If you are eligible for Medicare Part A, you can enroll in Part B and pay a monthly premium as well as an annual deductible.

Medicare Advantage, or Part C is a combination of options included in Parts A and B to cover almost all medical services. Part C is offered through private insurance companies approved by Medicare, and while you do have to pay a monthly premium, Part C often costs less than the Original Medicare plan while offering extra benefits such as covering annual physicals, vision insurance, and sometimes, prescription coverage. Senior Medicare Advantage has networks that include Medicare Health Maintenance Organizations (HMOs), Medicare Preferred Provider Organizations (PPOs), Medicare Private Fee-for-Service (PFFS), Medicare Special Needs, and Medicare Medical Savings Account (MSA). With an HMO, you must see a doctor within the HMO network, while with a PPO, you can see any doctor or specialist, but if that person isn’t in the network, your costs will go up.

Medicare Part D provides a prescription drug coverage to help you lower your prescription drug costs. If you are already enrolled in Medicare Part A, B, or C, you can enroll in Medicare Part D and pay a monthly premium to the insurance provider. But if you are covered under Medicare Advantage and belong to an HMO or PPO, it probably offers some prescription drug coverage. Some Medicare plans for seniors have coverage gaps which is why you may elect to purchase a Medigap insurance policy though a private insurance company to get help paying for some of the healthcare costs not covered by your Medicare plan, such as emergency healthcare outside the United States.