For more than 40 years, the United States has had health insurance called Medicare. During this time, it significantly crowded out other insurance plans in the struggle for the consumer. Today, this system covers the medical expenses of 40 million people, mainly the elderly. It pays about half of all treatment costs for those over 65. Medicare, however, does not cover a number of medical services and seems to pay only a small part of other services. In order to maximize the benefits of what Medicare in Colorado offers and to avoid unjustified costs, you need to know how this system works.
So what is Medicare?
This is a federal program that helps older people and people with disabilities pay for medical services. It consists of part A and part B. Part A is hospital insurance, which covers the cost of staying in the hospital, as well as some expenses for subsequent treatment. Part B is medical insurance that pays the cost of visiting doctors and outpatient treatment.
The Medicare program consists of 4 parts: part A, part B, part C, and part D.
- Part A is hospital insurance that helps cover hospital treatment for patients in hospitals, nursing homes, hospices, and home treatment. Most people do not pay premiums for Part A, because Medicare taxes are paid during work hours. If you are not entitled to Part A without an insurance premium, then you may be entitled to purchase Part A if certain conditions are met;
- Part B is medical insurance that helps cover services such as doctors, ambulatory care, durable medical equipment, home health care and other medical services, as well as some preventive services. Participation in Part B of the Medicare program provides for a monthly fee;
- Part D is a prescription drug coverage that helps cover the cost of certain prescription drugs for treatment. Subscribing to Medicare Part D is voluntary; use of it involves an additional monthly insurance premium;
- Part C (Medicare Advantage). If you benefit from Part A and Part B benefits paid by the federal government, your coverage is called Original Medicare. If your benefits are provided by Medicare Advantage or another Medicare-approved private company, your coverage is called Medicare Advantage. Many Medicare Advantage plans provide additional services and may reduce your medical expenses. If you have Part A and Part B, you can join the Medicare Advantage health plan. With this plan, you won’t need Medigap supplemental insurance, because Medicare Advantage plans offer the same benefits as Medigap supplemental insurance. This includes, for example, paying extra hospital days after you used Medicare paid days.
Permanent residents of the United States who are over 65 years old will automatically subscribe to Medicare Part A when they begin to receive a pension from the Social Insurance Fund. If you are not yet 65 years old, but you are eligible to participate in the program for other reasons, contact your nearest social insurance department for information on joining the program.
As a rule, to receive these benefits under Medicare Part A without paying an insurance premium, you must work in the United States for a total of ten years (or 40 quarters) during your life. For more information about the Medicare program, visit www.medicare.gov.
How is Medicare different from Medicaid?
Many people do not understand the difference between these two federal programs. The medicare is designed to help older people pay for treatment costs, which are generally much higher than for younger people (given that the ability to cover these costs with earnings decreases over the years). People who earn it by paying social security taxes receive Medicare. Medicaid, on the other hand, is a health insurance program for those in financial need. This program is controlled by the federal government but is implemented with some differences in each state. Although in some cases you can apply for the benefits of both Medicare and Medicaid, nevertheless, they have different requirements. In addition, Medicaid may cover a number of services that Medicare does not pay.