Medicare Benefits | Parts of Medicare and the Eligibility

Medicare refers to a governmental program that gives medical insurance coverage for retired persons over age 65 or for others who meet specific medical conditions, such as having a disability.

Medicare Benefits Parts of Medicare Eligibility

History of Medicare

There were amendments made to the Social Security program. Therefore Medicare was signed into legislation in 1965 and is controlled by the Center for Medicare and Medicaid Services (CMS) you can check via under the jurisdiction of the Department of Human Services.

Medicare Part A, B, C, and D Eligibility?

Although it is not perfect, medicare provides medical insurance coverage for over 43 million Americans, many of whom have no medical insurance. Medicare offers them relatively low-cost basic insurance but doesn’t do much in terms of preventative care like annual physical vision care or dental care.

Age-Based Eligibility – People from age 65 or older are eligible for Medicare.

Disability-Based Eligibility – People at the age of 65 with certain disabilities may also be eligible for Medicare.

End-Stage Renal Disease (ESRD) Eligibility – People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) of any age may also be eligible for Medicare.

Citizenship or Legal Residency – To qualify for Medicare, you must be a U.S. citizen or a legal permanent resident who has lived in the United States continuously for at least five years.

Medicare is catered for by means of payroll tax deductions (FICA) equivalent to 2.9% of wages; the employee and employer pay half each.

There are four Parts of Medicare:

  • Part A deals with hospital coverage,
  • Part B deals with medical insurance,
  • Part C deals with supplemental coverage
  • Part D deals with prescription insurance.

As earlier said, none of these parts have their cost entirely paid for, and parts C and D especially come with added charges. There is always a premium, co-pay, and a deductible. Some low-income people also qualify for Medicare, which assists in paying part of their out-of-pocket costs.

Medicare Prediction

To the fact that the rate of people joining the “retiree group” and becoming eligible for Medicare is significantly higher than people paying into the system.

It was initially predicted that the system will go bankrupt by 2018, however despite the fact that healthcare costs are continually on the increase amidst reports of fraudulent financial activities by dubious individuals over the years thus adding to the financial woes of Medicare, the system is still functioning today.

What Does Part A Medicare Cover in USA?

Medicare Part A is the hospital insurance component of the U.S. federal health insurance program for people aged of 65 and older, as well as some younger people with certain disabilities or End-Stage Renal Disease (ESRD). The main purpose of Medicare Part A is to help cover inpatient hospital care and related services.

Services Covered by Medicare Part A

Inpatient Hospital Care: This includes semiprivate room accommodations, meals, general nursing care, medications, and also other medically necessary services received during a hospital stay.

Skilled Nursing Facility (SNF) Care: Medicare Part A covers a limited stay in a skilled nursing facility following a qualifying hospital stay. It covers skilled nursing care, rehabilitation services, and also other related services.

Hospice Care: Part A covers hospice services for people with a terminal illness or condition. It includes palliative care, pain management, counseling, and other supportive services for both the person and his/her family.

Home Health Care: Medicare Part A covers some certain medically necessary home health services, like skilled nursing care, physical therapy, and occupational therapy, when ordered by a doctor.

Limited Blood Coverage: Part A covers the cost of blood transfusions you receive while an inpatient in a hospital or skilled nursing facility.

Isn’t that cool?

As it’s mentioned above Medicare Part A covers many hospital-related services, but it generally does not cover outpatient services, such as doctor visits, prescription drugs, or long-term care in a nursing home. Those services are typically covered under Medicare Part B (Medical Insurance) and Part D (Prescription Drug Coverage).

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