Medicare Explained

Medicare is a health insurance program run by the federal government. Generally, the program is meant for citizens who are aged 65 or above. Citizens who are under 65 can also enroll in the program if they meet certain requirements. Medicare helps the beneficiaries cover certain medical expenses and services. In exchange for the medical services covered under the program, Medicare enrollees must pay certain premiums, deductibles, copayments, and other costs specific to the plan.

There are some eligibility requirements you must meet to qualify for Medicare. First, you must be 65 years or older, except for in certain circumstances, such as having a disability. If you receive Social Security disability benefits, you can enroll for Medicare after the 24th month of receiving benefits.

Also, people who have End-Stage Renal Disease and Amyotrophic Lateral Sclerosis automatically qualify for Medicare. Lastly, you must be a citizen of the United States or a permanent resident for at least five years to be qualified for Medicare.

Parts of Medicare

Medicare is divided into different parts. Original Medicare consists of Medicare Part A and Part B, while Part C is also known as Medicare Advantage. There are other parts such as Part D and Medicare Supplement plans (Medigap).

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Part A

Medicare Part A alongside Part B constitutes Original Medicare. Medicare Part A covers the cost of inpatient hospital services, skilled nursing facility care, hospital insurance, hospice care, and certain home health services. Medicare Part A and Part B have the same eligibility requirements. If you enroll for Part A, there are some costs you are to cover in exchange for the services offered by the plan.

For most Medicare enrollees, Part A is premium-free. However, if you have not paid up to 40 quarters of Medicare taxes, you will pay a monthly premium, depending on the amount of Medicare taxes you paid while employed.

Part B

Part B is also part of Original Medicare. Medicare Part B covers outpatient hospital services, doctor visits, lab tests, mental healthcare services, preventive screenings, durable medical equipment, and ambulance services. While most people qualify for premium-free Part A, Part B typically requires a monthly premium payment. For 2021, the average Part B premium is $148.50. The cost of the premium may be higher for enrollees with a high income.

Once you meet the annual deductible of $203 for Part B, you will only pay for 20% of the approved costs for specified services under Medicare Part B.

Medicare Advantage

Medicare Advantage is alternatively known as Medicare Part C. While Original Medicare is provided by the government, Part C is offered by private insurers contracted with Medicare. Medicare Advantage plans cover the same services as Original Medicare. However, most Medicare Advantage plans include prescription drug coverage, dental and vision, and other services not covered by Original Medicare.

Part D

Medicare Part D covers prescription drug coverage services. Like Medicare Advantage, Part D is also provided by private insurers that are contracted with Medicare. You can either purchase a standalone Part D plan or enroll in a Medicare Advantage plan with prescription drug coverage.

Medigap

Medicare Supplement plans are also known as Medigap. Medicare Supplement plans do not replace Original Medicare. Instead, they supplement Original Medicare. Medigap plans help to cover the out-of-pocket costs associated with Original Medicare. There are ten standardized Medigap plans lettered from A to N.

Reach out to us today at 800-971-2989 for more information and help with Medicare plans in Nebraska.

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