Medicare is a health insurance plan provided by the Government that assists those who are 65 years of age or older. Younger people may be eligible for Medicare if they have a disability or chronic disease. It helps reduce healthcare expenses for the person, but it won’t cover all medical costs or long-term care. As you get closer to age 65, you may want to start reading up on the basics of Medicare so you can understand what medical expenses are covered under it.
To receive Medicare, you must first qualify for it.
Who Qualifies For Medicare?
To qualify, you must:
- Be 65 or older—For applicants above the age of 65, it is required that they are a US citizen or a permanent legal resident who has resided in the US for over five years. They must also be eligible for social security benefits or railroad retirement. Another qualifier is if you or your spouse are government employees.
- Have a disability—Applicants under 65 must be eligible for social security and RRB benefits.
- Be ailing with permanent kidney failure
- Be diagnosed with Lou Gehrig’s disease
If you do not qualify for Medicare, you can get Medicare by paying for the benefits.
If you receive Social Security benefits, you will be enrolled automatically in Medicare Part A, which focusses on hospital costs, and Part B, which focusses on physician visits. If you want to enroll in Medicare Part D for prescription coverage, you must register yourself.
If you do not receive Social Security benefits, you can enroll through the Social Security Administration website.
Parts of Medicare
1. Part A – Hospital Insurance
Part A of Medicare, also known as hospital insurance, provides inpatient and hospital stays, lab tests, and nursing facility stays.
If you or your spouse paid Medicare taxes for a specific timeframe while working, you typically would not have to pay a monthly premium.
If you do not qualify for a free premium, you can purchase Part A through standard monthly premiums. Someone who paid Medicare taxes for less than 30 quarters will get a $458 standard premium every month, and one who paid 30-39 quarters receives a $252 standard monthly premium.
2. Part B – Medical Insurance
This part covers doctor visits, outpatient care, medical supplies, preventive services, outpatient care, and home health visits. Part B of Medicare is the part that everyone pays through monthly premiums.
However, your modified adjusted gross income must be above a certain amount to pay for the premiums. If it is, you will pay a standard premium amount and an Income Related Adjustment Amount.
3. Part D – Prescription Drug Coverage
Part D helps with the cost of vaccines, shots, or prescription drugs. This Part is not included in the original Medicare, but it is part of the medicare advantage plan. If you want it in the original medicare plan, you would have to purchase it separately.
If you have turned 65 or suffer from a qualifying chronic illness, it may be time for you to start thinking about which Medicare Plan option you wish to enroll in.
Medicare gives you two options to get your coverage. One option is the original Medicare that includes part A and part B plans. The other option is the Medicare advantage with all the parts, including part D. Note that each option has its rules and charges for getting various services; read more about options here.