Guide To Health Insurance.org

Medicare is a federal health insurance program. It provides health care aid to Americans who are over the age of 65, or who have kidney failure which requires dialysis or a transplant. Medicare was signed into existence by President Lyndon B. Johnson as an amendment to previously existing Social Security legislation. Medicare is currently a source of great debate, and its need for reform is frequently called upon. Unless changes to the current system are made, Medicare will eventually go bankrupt as health care costs escalate and aging baby boomers seek coverage.

Benefits

Medicare is structured in four parts, A through D. Because there are different parts that cover different areas, and programs can vary from region to region, some seniors find Medicare difficult to understand.

Part A pertains to hospital insurance. This is to provide for both hospital and nursing home stays. Nursing home charges are only covered if a problem was diagnosed during a hospital stay, or if the nursing home stay is for the same reason as the hospitalization.

Part B pertains to doctor's fees, outpatient hospital care, and medical devices such as canes, walkers, wheelchairs, etc. Medicare pays for these services in the same way they would be covered through other types of insurance plans. You can choose to go to any doctor, hospital, or community mental health center that participates in Medicare's program. The only difference is that depending on where you receive medical treatment, and the type of treatment involved, your benefit coverage may change from year to year, even if you're receiving the same treatment or service. Gradually, over time, your out-of-pocket expenses will decrease in order to save you money.

Part C is an option allowing Medicare beneficiaries the ability to receive their Medicare benefits through their own private HMO or indemnity insurance plan. This is permitted in lieu of receiving benefits through Plans A and B.

Part D represents a recent reform aimed at helping ease the financial problems many seniors face. Created by the Medicare Drug, Improvement, and Modernization Act, Medicare Part D went into effect on January 1, 2006. As drugs costs continue to skyrocket and as more drugs are prescribed to more seniors, it became increasingly apparent that some sort of relief was needed to help seniors on fixed incomes to get the medication they require. This is a stand-alone prescription drug plan that seniors must enroll in separately from Medicare. These plans are administered by private insurance companies that receive large government subsidies in order to offer significant discounts. Anyone on Medicare can get coverage, regardless of health or income. Plans and coverage vary depending on what drugs you use, your income, and your drug costs.

Help with Medicare

If you have questions about Medicare, call your local or state Social Security office for more information.