So what is Medicare?

Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are either age 65 or over, or meet special criteria. It was originally signed into law on July 30,1965 by President Lyndon B. Johnson as amendments to Social Security legislation.

In general, individuals are either eligible for Medicare if they are a US citizen or have been a permanent legal resident for 5 continuous years, and they are 65 or older. OR, they are under 65, disabled, and have been receiving either Social Security or the Railroad Retirement Board disability benefits for at least 24 months, or they get continuing dialysis for permanent kidney failure or need a kidney transplant, or they have Amyotrophic Lateral Sclerosis (ALS-Lou Gehrig’s disease). Insurance for Seniors, LLC. is here for you every step of the way.

Medicare has 4 parts…

Part A Hospital Insurance –

Most people don’t pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Part B Medical Insurance –

Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctor’s services and outpatient care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some health care. Part B helps pay for these covered services and supplies when they are medically necessary

Part C Medicare Advantage Plan –

Most people will pay a monthly premium for this coverage. Starting January 1, 2006, new Medicare prescription drug coverage will be available to everyone with Medicare. Everyone with Medicare can get this coverage that may help lower prescription drug costs and protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they must pay a penalty if they choose to join later.

Part D Prescription Drug Plans –

On January 1, 2006, Medicare Part D went into effect. Beneficiaries with Part A or B are eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a beneficiary with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases.

Learn More about Medicare.

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