Over 30 million Americans, mostly the elderly, used Medicare in 2010.
Most people qualify for Medicare when they turn 65 years of age. It is possible to qualify at a younger age if you have end-stage kidney failure or certain disabilities, but the program is primarily designed for senior citizens. Medicare comes in four parts and is offered both by private companies and the U.S. federal government. The parts of Medicare in which you can enroll depends on your health needs, available plans in your area and budget.
Medicare Part A
Medicare Part A is the first Medicare option you can enroll in once you become eligible. Part A is premium-free for both you and your spouse if you have paid Medicare taxes for 40 quarters, or 10 years. If you have not done this, you can still get Medicare Part A if you pay a monthly premium, based on how many quarters you did pay Medicare taxes. Part benefits include in-patient hospitalizations coverage, home health services and hospice care.
Medicare Part B
Along with Part A, Part B is considered original or traditional Medicare. If you are eligible for Part A, you are also eligible for Part B. However, you do not have to enroll in Part B. If you are automatically enrolled because you already receive Social Security benefits, you can opt out by following the instructions on your Medicare card. Part B always requires a monthly premium payment. Many services also require co-pays, deductibles or co-insurance. Benefits for Part B are primarily preventive, such as health screenings, a yearly physical and smoking-cessation programs. Part B also covers medical supplies and services needed to diagnose or treat a health condition.
Medicare Advantage (Part C)
Traditional Medicare is purchased directly from the government, but Medicare Advantage plans are bought from private insurance companies approved by the Centers for Medicare and Medicaid Services. Medicare Advantage (MA) combines all the benefits of Parts A and B, except for hospice, with additional benefits. Individual companies may choose which benefits they want to offer in their MA plans; these often include eye exams, hearing aids, prescription medications or dental work. Medicare Advantage premiums, deductibles and co-pays are set by the insurance company that offers the plans. MA policies can also be sold in different ways, including as HMOs, PPOs, special needs plans, private fee-for-service policies and plans that can be used with medical savings accounts.
Medicare Part D
Part D is an optional Medicare plan also sold by private companies. Part D offers prescription drug benefits only. If you already have prescription drug benefits through a Medicare Advantage plan or other insurance, you do not need to buy Part D. To join a stand-alone Part D plan, you must first be enrolled in either Part A or Part B. If you want to receive your Part D benefits through an MA plan, you will need to be enrolled in both Part A and Part B.
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