Medicare, Explained
By Erin Thompson, Social Security Public Affairs Specialist
in Toledo, OH
Guest Column
Social Security and
Medicare have a few things in common. Both programs help
safeguard millions of Americans as well as improve the
quality of life for our family and friends. Although both
programs are household names, many people may not be
familiar with the details of Medicare.
Medicare is our country’s health insurance program for
people age 65 or older. The program helps with the cost of
health care, but it doesn’t cover all medical expenses or
the cost of most long-term care. You have choices for how
you get Medicare coverage. If you choose to have original
Medicare coverage, you can buy a Medicare supplement policy
(called Medigap) from a private insurance company to cover
some of the costs that Medicare does not.
Medicare has four parts:
o
Medicare Part A (hospital insurance)
helps pay for inpatient care in a hospital or skilled
nursing facility (following a hospital stay). Part A also
pays for some home health care and hospice care.
o
Medicare Part B (medical insurance)
helps pay for services from doctors and other health care
providers, outpatient care, home health care, durable
medical equipment, and some preventive services.
o
Medicare Part C (Medicare Advantage)
includes all benefits and services covered under Part A and
Part B. Some plans include Medicare prescription drug
coverage (Medicare Part D) and other extra benefits and
services.
o
Medicare Part D (Medicare prescription drug coverage) helps cover the cost of
prescription drugs.
Some people with limited resources and income may also be
able to get Extra Help with the costs—monthly premiums,
annual deductibles, and prescription co-payments—related to
a Medicare prescription drug plan. The Extra Help is
estimated to be worth about $4,900 per year. You must meet
the resources and income requirement.
Medicare’s different parts are further explained in our
publication at
www.socialsecurity.gov/pubs/EN-05-10043.pdf.
If you can’t afford to pay your
Medicare premiums and other medical costs, you may be able
to get help from your state. States offer programs for
people eligible for or entitled to Medicare who have low
income. Some programs may pay for Medicare premiums and some
pay Medicare deductibles and coinsurance. To qualify, you
must have Medicare Part A and have limited income and
resources. You can learn
more about Medicare, including how to apply for Medicare and
get a replacement Medicare card, at
www.socialsecurity.gov/benefits/medicare.
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