Medicare in the United States: 3 Important Factors

Medicare in the United States is federal health program for persons over 65. Enrollment for Medicare is not based upon income or health records. We have broken down who is eligible, plans available, and what ObamaCare means for seniors.

1) Who is Eligible for Medicare?

The majority of seniors 65 and over in the U.S. are entitled to Medicare Part A (hospital coverage) if they or their spouse are eligible for Social Security payments and have made payroll tax contributions for 10 or more years. Both Part A & Part B are described in detail below. Click here to see a Medicare Overview.

2) How does ObamaCare affect Medicare?

There has been some talk that the Affordable Care Act, AKA ObamaCare, would decrease Medicare benefits, however it has actually strengthened some areas of health coverage for seniors, but may cost higher earners more.

• $0 Preventive Care
• Closing the Donut Hole in Part D Coverage
• Premium increases for higher income persons
• Payroll tax for higher-income persons

3) What are my Medicare Options?

These five options make up Medicare:

1) Part A covers inpatient hospitalization, skilled nursing facility stays, home health visits, and hospice care. Part A benefits are subject to a deductible of $1,216 per benefit period in 2014, and coinsurance. It is important to note that Part A offers 90 day hospitalization coverage each year, and an additional 60 day lifetime max. If you were to end up spending 150 days in the hospital one year, all subsequent years you would only have Medicare coverage for 90 days. What does that mean? It means you would pay all future out of pocket costs for hospitalization for every day past 90 days.

2) Part B covers doctor’s office visits, mental health, outpatient care, preventive services, and home health visits. Part B benefits are subject to a deductible of $147 in 2014, coinsurance, and copays. Go to our Medicare Overview Page to sign up today.

3) Part C refers to the Medicare Advantage program, which is a plan through a private provider, which offers all of Medicare’s benefits but within a smaller network. Sometimes these budget plans cover your Medicare Premiums, as well as add on prescription coverage -which is not included in Original Medicare. Click here to compare Medicare Advantage and Medigap Policies.

4) Medigap is a federally regulated but privately provided plan to ride along side of Medicare. The purpose of this plan is to fill in the gaps of Medicare. It is a more expensive plan than Medicare Advantage, but its basic plan covers Part A and Part B coinsurance as well as blood transfusions. More comprehensive Medigap plans cover deductibles and foreign travel. But most importantly Medigap extends hospitalization. Go to our article about Medigap: Compare Basic to Comprehensive Plans side-by-side.

5) Part D is drug coverage offered through a private provider. It helps cover the costs of increasingly expensive prescriptions. Take note this is not part of Original Medicare or Medigap. Read more about Prescription Drug Plans: Medicare Part D.

Conclusion

For the greatest Medicare coverage for U.S. residents get both Medicare Part A & B, Medigap, and Part D. Why not Medicare Advantage? We aren’t ruling out MA for those on a tight budget, because it is still a better option than only having Original Medicare, but if you have a little extra money to spend Medigap will offer you greater financial protection in case of major medical issue.

Any further questions about Medicare call 800-930-7956 or contact Senior65.com for assistance.