Medicare is a federally-funded health care insurance program.
A federal health care program, Medicare allows those 65 or older or disabled to receive health care benefits. This program provides coverage to all of those eligible, regardless of income. Funded by tax dollars, Medicare had 724, 356 enrolled Kentuckians in 2008. There are three different plans under Medicare coverage: Plan A, Plan B and Plan D. Many Kentucky residents also opt for supplemental insurance to help with the part of the medical bills that Medicare does not cover. Some can also participate in Medicare Advantage, or Plan C, which provides all the services covered in Plan A and Plan B, with additional coverage such as dental, vision and emergency care.
Plan A
In Kentucky, eligibility for Plan A is available to seniors 65 or older or disabled persons under the age of 65. This plan comes free of charge if the person or their spouse has paid into Social Security for at least 10 years. Plan A covers short-term hospital visits yet does not provide for long-term health care. This also includes visits to nursing care facilities and home hospice care. When a person begins their inpatient care under this plan, they enter a benefit period which continues until they have remained out of the hospital for 60 consecutive days. This plan requires patients to pay a deductible before Plan A begins to cover the inpatient costs.
Plan B
Plan B provides coverage to all citizens over 65 even if they meet the requirements for Plan A coverage. Plan B requires a monthly premium from those enrolled and provides assistance with most outpatient medical costs. Doctor visits, most preventative medical exams such as X-rays and mammograms, medical equipment like wheelchairs and braces, ambulance services, and medication given during a doctor visit are all covered under Plan B. Medicare Plan B typically pays for approximately 80 percent of the medical costs, depending on the nature of the visit and care provided, as it does not cover certain types of procedures.
Plan D
Those in Kentucky who rely on prescription drugs can opt for Medicare Plan D. Plan D supplements Plan A and Plan B by providing assistance in covering the costs of prescription drugs. Enrollment in this plan is optional, yet all who are under Plans A or B may sign up. Plan D requires a monthly premium in addition to premiums paid to the other parts of the Medicare plan. Plan D also requires that policy holders meet their deductibles before coverage begins, which is about 75 percent of the original prescription cost. Yet, Medicare Plan D sets a cap on the amount it will pay on drugs per year, so the patient must pay out of their own pocket when they reach this amount. Still, those on a low income can receive a subsidy to help pay for what Medicare does not cover.
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