Social Security Medicare
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Medicare is a Federally uniform program. That means that no matter what state you are in your benefits don’t change. This is a health insurance program specifically designed to provide benefits to; people over 65, people with disabilities that are under 65; and people of all ages with End-Stage Renal Disease. This insurance has a deductible that needs to be met for most services and supplies.
Hospital insurance (part A)
Hospital benefits, as a rule, have already been paid by the Social Security payroll tax by either the individual or their spouse so there is no fee for these. This benefit covers helps cover inpatient hospital care. Though it covers critical access hospitals and skilled nursing facilities it does not cover long-term or custodial care facilities. Some home health care and hospice care are also covered under part A. Certain conditions must be present to qualify for these benefits.
Medical Insurance (part B)
There is a standard monthly premium due for Medicare’s medical insurance. There are rare instances when there are no premiums. Part B is for medical services not covered under part A. Doctor’s office visits, outpatient hospital care, home health and physical and occupational therapists services fall into this area of coverage. Covered medically necessary services and supplies are paid for through part B benefits.
Prescription Drugs (part D)
As of January 1, 2006 all Medicare recipients are eligible for prescription drug coverage. This is the most confusing aspect of all Medicare coverage. The options available for prescription drug coverage are immense. There are plans available due to the privatization of Medicare that provide part D coverage along with part A and part B coverage. There are private companies that provide part D coverage that have real low cost share amounts on generic and specific meds while having very high costs on meds that are not part of their formulary. Some very expensive meds are not covered and so beneficiaries are given the option of paying out of their pocket (without it going toward the minimum) or going with a generic form or having to use less optimal medications for coverage. There is a Medicare gap that can have a devastating effect on some high medication patients. Medicare has online help for choosing a provider for part D but it is up to the individual to find the option that is best suited to him. There are limited times that a person may change or enroll in a prescription drug plan. If a person does not choose to enroll when he first become eligible than penalties will be incurred if he decides he wants to join at a latter date. There is a yearly or monthly premium for this insurance that varies greatly from plan to plan.
Related Posts
- The Medicare Gap or Donut Hole
- Medicare Drug Plans
- Social Security 101
- Medicare Catastrophic Drug Coverage
- Social Security Administration
- Medicare Drug Plan Formulary
- Social Security Medicaid
