Medicare added a prescription drug benefit in 2003.
The Medicare Act of 1965 established Medicare insurance for the elderly to help defray the costs of hospitalization and medical expenses. Medicare is a federal program that provides health insurance to those 65 and older and for the disabled. People who participate in Medicare receive a wide range of much-needed health care services.
Eligibility
In order to receive Medicare a participant must be 65 or older or have certain conditions such as end-stage renal disease or Lou Gehrig's disease. Spouses of a beneficiary may also qualify, along with people who received Social Security disability payments for two years. Some government workers who paid for Medicare through payroll tax may be eligible.
Medicare Overview
Original or traditional Medicare is made up of Part A and Part B for hospitalization insurance and medical insurance. This fee-for-service program allows participants to see any doctor in the country who accepts Medicare. Prescription drug coverage, an optional program, was signed into law in 2003. Some people elect a Medicare Advantage program, Part C, instead of traditional Medicare. Medicare Advantage combines the benefits of Parts A and B, with the option of including Part D. Medicare covers a portion of expenses related to hospitalization, medical expenses and prescription drugs. Some people with traditional Medicare take out "gap insurance" to cover the costs of deductibles and co-pays.
Medicare Part A Benefits
Most people do not pay a premium for Part A benefits. Part A covers some of the costs of inpatient hospital care with meals and prescription drugs. Benefits may also cover inpatient rehabilitation facilities and care in a nursing facility under certain circumstances. When it is medically necessary, hospice and home health care services may be provided such as skilled nursing, speech therapy, and physical therapy. Medical supplies and equipment such as wheelchairs and walkers may also be covered.
Medicare Part B Benefits
Participants in Medicare Part B pay a premium monthly for the coverage. Part B Medicare insurance covers outpatient services such as the cost of doctors and necessary medical services. Included in Part B are benefits like ambulance services, some surgery, transplants, mental health care and physical therapy. In addition, more and more preventive medical services are offered through Medicare Part B. This can include diagnostic testing such as MRIs, EKGs, CT scans and x-rays. Screening for a variety of medical problems may also be included, such as colorectal cancer screening, HIV tests, pap tests and hearing tests. Durable medical equipment like oxygen and hospital beds is offered through Part B
Medicare Part D Benefits
Part D offers prescription drug coverage. Participants should consult the "formulary" to see which drugs are covered and to what degree. A coverage gap referred to as the "doougnut hole" occurs when Medicare has paid out a designated dollar amount for drugs, and the individual is no longer covered. The doughnut hole ends once a certain dollar amount has been paid out of pocket.
Tags: Medicare Part, health care, Medicare Part Benefits, Part Benefits, Part Medicare, traditional Medicare
