Medicare is federal health care program offered to U.S citizens aged 65 or older and to younger citizens with certain disabilities. It is also for citizens of all ages who are suffering from End stage renal disease like kidney failure. However, it does not cover all medical expenses or the cost of most long-term care.
Medicare has the following parts:
Part A: Hospital Insurance – This helps cover inpatient care in hospitals, skilled nursing facilities and some home healthcare.
Part B: Medical Insurance – It helps cover doctor’s services and any other medical services not covered by Hospital Insurance.
Part C: Medicare Advantage – People with Medicare Part A and Part B can choose to receive all their medical services through one of these provider organizations under Part C.
Part D: Prescription Drug coverage – This coverage help lower prescription drug cost and protects against higher cost in future.
Out-of-pocket expenses
Neither Part A nor Part B of Medicare policy pays for all of a covered person’s medical costs. The program contains premiums, deductibles and coinsurance, which the covered individual has to pay out-of-pocket.
Premium
Most Medicare enrollees do not pay a monthly Part A premium, because they (or a spouse) have had 40 or more 3-month quarters in which they paid Federal Insurance Contribution Act taxes. Medicare-eligible persons who do not have 40 or more quarters of Medicare-covered employment may purchase Part A for a monthly premium.
All Medicare Part B enrollees pay a premium for this coverage that is commonly deducted automatically from beneficiaries’ monthly Social Security checks.
Medicare Part C and Part D plans may or may not charge premiums and it is at the programs’ discretion. Part C plans may also choose to rebate a portion of the Part B premium to the Medicare holder.
Benefits of Medicare plan
Here are the following benefits on Medicare plans:
- Low monthly payments: Most of the times the monthly payments are low and are deducted from a person’s social security check making the plan very affordable.
- Does not limit the choice: You can consult any doctor or service provider of your choice. The healthy provider might not be from the listed provider. However, it is advisable to consult health providers from within the network to enjoy full benefits of the plan.
- Additional benefits offered: Additional benefits can include vision and dental coverage.
Drawbacks of Medicare plan
The following are the drawbacks of Medicare policy:
- Does not cover costly treatment: Most of the time Medicare plan refuses to pay for the costly treatments, especially for the experimental therapies. If you become very ill, your insurer might become increasingly reluctant to cover your medical expenses.
- Does not cover all costs: It does not pay all the medical expenses. There are cost like coinsurance, co-payments and deductibles which you must pay.
Medicare programs do not provide coverage for all treatments and medical expenses. So, it is important that you have proper information about the coverage before you receive any treatment.
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