Medicare Basics

Medicare is the federal government's health insurance program for those over 65 years of age and those who have been on Social Security Disability for more than 24 months.  An individual (or their spouse) must have worked for 10 years (40 quarters) to receive premium free Part A.

Part A of Medicare is the portion that helps pay for in-patient medical care.  The insured must pay the $1,187 deductible and Medicare will pay for the rest of the hospital stay.  This is repeated for each hospital stay that begins more than 60 days after the last hospital stay.

Part B of Medicare is the portion that helps pay for doctor visits and outpatient services.  The insured must pay the $147 annual deductible and after that 20% of the Medicare approved amount for medical services.  Medicare will pay the other 80% of the medicare approved bills.  A medical provider that accepts Medicar assignment is not allowed to charge the insured any additional amount.  A medical provider that does not accept Medicare assignment may charge the insured up to 15% more for services.  

Medicare Supplement plans and Medicare Advantage plans are designed to pay at least a portion of the medical costs not covered by Medicare.  Prescription drug are not covered by Medicare.  Part D plans are designed to help pay for prescription medications.  Medicare imposes a penalty for each month that a Medicare recipient goes without prescription drug coverage.

Medicare does not cover prescription drugs, vision exams, glasses and contacts, and most dental care.  These benefits may be be available as part of a Medicare Adcantage plan.  Only the prescription drug coverage can be obtained separately.

RELATED SUBJECTS:

Medicare Advantage plans

Medicare Suplement plans

Medicare Part D plans

Part D penalty