About Medicare

Medicare is a federal health insurance program, primarily for the elderly and people with disabilities. Medicare comes in three parts: Part A, Part B, and Part...See more » Medicare is a federal health insurance program, primarily for the elderly and people with disabilities. Medicare comes in three parts: Part A, Part B, and Part D. Part A covers inpatient hospital care, inpatient care in a skilled nursing facility , home health care services, and hospice care, and everyone on Medicare automatically receives Part A. Part B covers visits to your doctor, durable medical equipment (i.e. things like wheelchairs), and some outpatient and home health care services that are not covered under Part A. If you have Part A, you can pay a monthly premium to get Part B. The new Medicare Part D, the prescription drug benefit, began January 1, 2006. To learn more about Medicare prescription drug coverage under Part D, take a look at the HealthCareCoach.com article, "Can I Get my Prescription Drugs from Medicare?" Medicare has changed in other ways. To find out about the other recent changes to Medicare, take a look at the HealthCareCoach.com article, "What's New in Medicare?" Who is eligible for Medicare? People over 65 who are entitled to Social Security retirement benefits and adults of any age who are entitled to Social Security disability benefits for at least 24 months may receive Medicare. People receiving Railroad Retirement or Railroad Retirement disability benefits may also receive Medicare. Medicare will also cover people with end-stage kidney disease. Most federal workers can count their government work toward Part A eligibility. Medicare and Medicaid are not the same thing. Eligibility for Medicaid, in part, is based on a person's income. Income and assets are not considered in determining whether someone is eligible for Medicare. Medicare is completely run by the federal government, while Medicaid has federal laws and rules, but each state runs its own Medicaid program. A person can receive both Medicare and Medicaid. A big difference in coverage is that Medicaid pays for long-term care, such as in a nursing home. Medicare does not. Medigap insurance is designed to fill the holes in Medicare coverage. Many people buy private insurance policies that cover some of the things that Medicare does not cover. This insurance is called "Medigap" insurance. This insurance may cover additional days in a hospital, parts of Medicare services that Medicare does not pay in full, or other medical needs that a person may have. With the new Part D, new Medigap policies will not cover prescription drugs. What is Medicare Advantage? Medicare Advantage, also known as Medicare Part C, is the managed care program under Medicare. This managed care program used to be called Medicare+Choice. Currently, most people who have Medicare have a fee-for-service arrangement. In the last few years, the federal government has arranged for private managed care plans to receive funding to give medical services to Medicare beneficiaries. These arrangements with private managed care plans were greatly expanded under the new Medicare Advantage program. Medicare Advantage generally covers the services under Parts A, B, and D, plus some additional benefits. Want to compare Medicare health plans? The Centers for Medicare and Medicaid Services, a federal agency, offers Medicare Personal Plan Finder to help you find the Medicare health plan that may work best for you. If you live in California, try the California Health Advocates Web site to learn about your options, how Medicare is changing, and to compare health plans. If you are trying to decide whether a Medicare HMO or a Medigap policy is better for you, you may want to look at a couple of articles by the California HealthCare Foundation comparing value and drug coverage in Medicare HMOs and supplemental policies. How do I apply for Medicare? If you fit one of the categories of people described above, you can apply for Medicare at your local Social Security office. To find out more about Medicare, take a look at this federal government Medicare web site that has basic information about Medicare, who can get it, and what it covers. You can also order brochures about Medicare and findSee less »