Medicare enrollment form
Medicare explained. Part 2. Image: Flickr.

Medicare coverage came into existence on the 30th of July 1965 when the then president, Lyndon b. Johnson made into a law in the United States. This program was designed to benefit citizens of the United States who were at the age of 65 and above. Nowadays, there have been changes in the Medicare program where aside from those who are of 65 years of age, there are others who can apply for this social insurance provided that they are in need due to health issues and have been paying their Social Security for two years or more.

Before, the coverage for Medicare applied only to two options and these were insurance for hospital or Plan A and medical insurance or commonly known as Plan B. The first official Medicare card was given to Harry S. Truman, a former president of the United States. However, the coverage doesn’t reach prescription medications. It was only in 2006 where a more comprehensive insurance coverage for Medicare were made available.

Medicare Coverage

Part A

When referring to Part A in Medicare this refers to insurance for Hospitals. This covers mostly the time you stayed in the hospital, home care assistance and nursing homes. There are certain criteria that need to be fulfilled first before availing of the benefits. The first one is usually assigned to the hospital you had stayed in. Another piece of criteria is for you to have stayed in the hospital for a minimum of three days and three nights at least. This does not include the time when you are discharged. If you are using medical assistance, this doesn’t cover those who are being cared by those who are unskilled or unfit for the job.

Part B

Part B usually refers to Medical Insurance. This type of Medicare covers mostly outpatients that don’t fall under Part A. It covers doctor consultation, immunosuppressant medications and even medical transport. Part B also helps in covering the expenses when purchasing DME or Durable Medical Equipment. DMEs include canes, prosthetic limbs and oxygen.

Part C

This covers mostly Advantage plans offered by Medicare. Recipients of Medicare were given the option to choose whether they will still be using the previous Medicare coverage or will they make the switch to private insurance providers. Those who preferred to receive their benefits through private insurance companies specializing in health insurance are referred to as recipients of Medicare Advantage.

Those who choose Part C has Medicare paying the private health insurance a specific amount. However, you need to pay the premiums including copayment that comes with a fixed rate whenever you visit your doctor. Based on the laws that govern the United States, the private health insurance must offer their clients benefit packages that are similar to that is being offered by Medicare.

Part D

In 2006, Medicare Part D covers plans for prescription drugs. Those who fall in Part A and B can be apply for Part D. If you are using Part C of Medicare you can make some changes on the benefits that you are receiving so it can cover Part D as well.

Cost of Medicare

When referring to the cost of Medicare, 2.9% of the wages that you earn are taxed before it is applied to your Medicare for your future. This cost is usually divided between the employer and the employee. Those who are self-employed are required to pay the full amount on their own.

Medicare works just like your personal insurance. Your care provider will be the one who will bill Medicare for the amount you have incurred while the rest will be coming from your pockets.