Medicare Explained

A Medicare plan is a federal health insurance scheme for individuals 65 years old or older, some young people who are disabled and individuals with renal disease end stage (chronic renal failure requiring transplant or dialysis, sometimes referred to as ESRD). If you or your spouse worked for 10 years or more, you may be eligible to receive Medicare Part A for free.

Part A includes inpatient hospitalization, nursing care, hospice care, and home care. What is covered by Medicare depends on state and federal laws, national coverage policy determined by Medicare on what should be covered, and decisions on local coverage by companies in each state that accept Medicare claims. These companies decide if something is medically necessary and should be covered in their area.

Medicare Part B has a monthly premium determined annually by Congress. Part B takes care of some medical services, outpatient care, medical care and preventive care. Some seniors are entitled to the part of health insurance (Part B), depending on income and assets. For more information, check with your County Social Services Office for the Qualified Medicare Beneficiary (QMB), the Special Low-Income Medicare Beneficiary (SLMB), and the Individual Qualification Programs.

Remember, in many cases, if you do not sign up for Part B, you will have to pay a fee for late enrollment fee so long as you have Part B. Your monthly bonus for Part B may increase by 10% for every full 12-month period during which you could have had Part B, but you have not signed up for it. You may also have to wait until the General Registration Period (January 1st to March 31st) to sign up for Part B, and reporting will start on July 1st of that year.

In general, you will not pay a late enrollment fee provide you pass some requirements that permit you to enroll for Part B within a special registration period.

Click here for a quote Medicare Part C (Medicare Advantage Plans) is a type of Medicare health insurance offered by a private insurance company that signs Medicare contracts to provide you with all your Part A and B profits. Medicare Advantage Plans include Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), Private Fee for Service Plans (PFFS), Medicare Medical Savings Account Plans (MSAs), and Special Needs Plans (SNPs).

If you sign up for a Medicare Advantage Plan, there many Medicare benefits which are covered by the plan but are not paid for in Original Medicare. Most Medicare Advantage plans contain prescription drugs.

Medicare Part D supplements some Medicare cost plans, Original Medicare, Medicare Medical Savings account plans, and some Medicare private fee-for-service plans for prescription drugs.

Medicare Advantage Plans could also provide prescription drugs that follow the same rules as Medicare Prescription Drug Plans. Remember, you may owe a late registration fee if you are without a Medicare Advantage Plan (Part C) (such as an HMO or PPO) or without a Medicare Prescription Drug Plan or other Medicare plan, Medicare offers coverage for prescription drugs or excluding eligible prescription medicines for a continuous period of 63 days or more after expiration of the initial approval period.