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Understanding our Federal Medicare Program

Written by Evens Stevenson

Medicare is an excellent program that provides healthcare to millions of Americans across the nation, but there is a large portion of enrollees or soon-to-be enrollees that don’t fully understand Medicare and all of the benefits that it provides.

Understanding the program and all of the advantages that it offers is one of the first steps for every enrollee. Otherwise, you could be missing out on some of the benefits that Medicare could provide for you. Similarly, there are several options for additional coverage that some participants aren’t taking advantage of, which could leave them with thousands of dollars of expenses out-of-pocket.

The History of Medicare

understanding medicareBefore we talk about the program, you need to understand where and how it was started. Lyndon B. Johnson originally signed Medicare into law back in 1965, but the idea for the program goes back much further than that. In fact, it goes all the way back to President Truman in 1945.

Today, the program has gone through several changes and expanded considerably since it’s initially signing, but it continues to provide health care for Americans that wouldn’t’ be able to afford it otherwise. It has completely changed the way that we look at health care.  In 2015, there were over 55 million enrollees in Medicare that were receiving benefits and services from Medicare.

The Different Parts of Medicare

There are several different parts of Medicare that cover different expenses. Part A Medicare is the first part, and it covers fees involved in hospital care, a skilled nursing facility, hospice, home health services, and nursing home care. With Part A, it will coverage expenses related to these areas, but there are some specific situations that you’ll have to meet before Medicare pays those bills.

The next part is Part B Medicare, which covers services related to any preventative services, or medically necessary services. This could include anything from clinical research, ambulance services, durable medical equipment, or much more.

While there are a lot of services and expenses that Medicare does pay for, there are a lot of things that it doesn’t, and figuring out if it will can be confusing, but there are two ways that you can figure out if your service or expenses will be covered under the program.

The first is by talking to your doctor or provider and asking them if it will be covered. They should be able to tell you if it will be covered, or how much of it will be paid for. If not, you’ll be able to contact a Medicare professional, and they can answer that question for you.

Another way that you can determine if the program is going to help pay for the health care is to use the official Medicare tool on their website. You can enter the good or service that you’ll be receiving, and the site will explain if it’s going to be covered.

The next part of Medicare is optional, which is Part C. The two previous parts, Parts A and B and required by law unless you fall under certain circumstances. Part C Medicare is also known as Medicare Advantage, and it helps fill in some of the holes that are left behind by Medicare Parts A and B. Each Medicare Part C plan is different and will cover various expenses depending on the provider.

The last part is Medicare Part D, which is more commonly known as prescription drug plans. These policies help enrollees offset the rising costs of medication, which can easily cost thousands of dollars every year. Purchasing a Part D plan is one of the few ways to protect yourself against the expensive bills that come with prescription drugs.

Why Medicare is Important

There is a lot of controversy surrounding the government program. Some people are in favor of the program, while others think it needs to be disbanded. Regardless of which stance you take, you can see the important of Medicare and everything that it provides.

Without the program in place, there would be millions of seniors every year that wouldn’t have the money that they needed to afford health care. It’s one of the most common reasons that elderly patients don’t get the medical attention that they need. Nobody should have to sacrifice his or her health because of money. That’s where Medicare steps in. There are several programs inside of Medicare that assists anyone that can’t afford to pay the premiums for Part B.

Medicare Supplemental Insurance

Aside from the four parts of Medicare, you can also purchase a Medigap policy, these policies give you additional coverage for the gaps A&B don’t cover. These Medigap policies are an excellent alternative to a Medicare Advantage plan (Part C).

Medicare supplemental insurance policies are sold by private insurance companies, each of the ten plans cover different expenses or various portions of those expenses. The plans pay for things like foreign medical emergencies and Part B excess charges.

Medigap plans are a great way to protect your bank account from the rising costs of healthcare that could quickly drain your savings otherwise. You couldn’t have to sacrifice your health, and these Medigap plans are the best way to ensure that you get the service and care that you need, without turning your retirement dream into a nightmare.

When you’re trying to decide which of the ten plans to choose from, there are several different factors that you’ll have to consider, like your health and your budget, both of these are going to play a major role in determining which policy type works best for you and your needs. If you have poor health, or several preexisting conditions, you may want to invest in a more comprehensive plan that fills in more of the gaps, like a Medigap Plan F.

Summary

Understanding Medicare is an important part of getting the healthcare that you deserve. Thousands of enrollees are confused about what is or isn’t covered under their policies, which can lead to several financial complications later in life.

We can look at your specific situation and help you decide which supplemental plan is going to work best for you. Don’t wait any longer to get the additional insurance coverage that you need to protect yourself from the rising costs of healthcare. We’re available at any time to answer questions, and alleviate any of your concerns.

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