What is Medicare? Is it health insurance or hospital insurance? Does it cost anything? Do I even need it? As one of the main battlegrounds of the last presidential election, Medicare has a place in the mind of every American; yet how many understand exactly what Medicare is, or what it can do for them? This article will explain the basics of this Social Security benefit and provide a base to take action from.
Medicare: What is it?
In 1965 the Social Security Act established Medicare and Medicaid in order to provide health care and hospitalization options for those who most needed them. Medicaid and Medicare are often thought of as the same program. The main difference is that Medicaid is primarily for low-income folk who cannot obtain medical care in another way; Medicare is primarily for citizens who are age 65 and older.
There are two main parts to Medicare; Part A (hospitalization) and Part B (doctor visits.) Between them they provide coverage for catastrophic illness or injury and routine health care, ensuring a basic level of health care coverage.
Who is eligible?
Anyone aged 65 or older is eligible who is also eligible for Social Security or Railroad Retirement benefits. Also, anyone suffering from end-stage renal disease and individuals who have received Social Security Disability Income for at least 24 months are also eligible.
What does it cover?
Each part of Medicare covers different aspects of health care coverage. It is important to know which is which in order to decide what you need. Below is a summary of the differences. For specific coverages important to you, you would contact the Social Security Administration at 1-800-772-1213.
• Part A: This covers some or all of your inpatient care in hospitals and in some cases other facilities, such as skilled nursing facilities, hospice care and some home health care.
• Part B: This covers outpatient hospital services, doctor visits, and in some cases prescription drugs. These services are covered if they are deemed medically necessary, but some preventative services are covered as well. Typically Part B will cover 80% of approved services (after the deductible is met.) There is also a subsidy for prescription drugs that provides a $600 credit for low income individuals.