CHASE - CREDITCARDS

Medicare and Its Many Options

Medicare is the U.S. government-run health insurance program for individuals over 65 and people who are disabled. While the program covers many different types of health care at no cost, there are limits to what it includes. Examples of items Medicare does not cover include cosmetic surgery, immunizations, regular checkups, nursing care in excess of 100 days, overseas medical care, and visits to doctors who have not joined Medicare. Medicare recipients in some cases still have to pay premiums, co-pays and deductibles. The program has three different levels of coverage.

Medicare Part A

This coverage level takes care of hospitalization costs for recipients, though the patient has to cover the deductible and, in some cases, co-payment. The policy will cover the first 60 days of your hospital stay, deductible aside. After that, it covers all costs of your stay beyond your co-pay up to the 90th day of your stay. Medicare Part A will also cover approved costs for the first 20 days of nursing home stays for patients who have spent three or more days in the hospital. It will then pick up the tab above co-pay until day 100.

Patients with terminal conditions not wishing to stay in the hospital can receive hospice care under this policy. Hospice is home-based care that emphasizes comfort over surgery and other medical treatments.

The program covers home health care costs and 80 percent of medical equipment costs. This type of coverage will also pay for blood transfusions after the first three pints of blood.

Medicare Part B

With this policy, around $54 a month will get you 80 percent of doctor and outpatient services. It is up to you to pay the remaining 20 percent. Covered services include lab work, blood work, biopsies, home medical care and blood transfusions after the first three pints. The policy also covers 80 percent of the cost of medical equipment used for home care.

Some doctors do not accept this type of insurance, so it is wise to check ahead of time. For every year you wait to enroll in the program after 65, your premium will increase by 10 percent.

You have the option of purchasing a supplemental insurance policy, or Medigap, through a private insurance company. This policy will cover what whatever costs Medicare Plan B excludes. There is a 6-month open enrollment period for Medigap, which takes place 3 months before and three months after your 65th birthday. If you miss this, you will likely be underwritten. For people in poor health, this often means denial of coverage.

Medicare C

A flexible option is the Medicare Plus Choice policy, which allows recipients to receive Medicare through a private insurance company of their choice. It is an alternative to Medigap. The program allows patients benefits not normally granted through basic Medicare plans. Instead of being locked into one type of plan, beneficiaries can select the kind of plan that suits them, such as an HMO (Health Maintenance Organization), PPO (Preferred Provider Organizer), MSO (Medical Savings Account), or PSO (Provider Sponsored Organization).

Medicaid

The Medicaid program aims to benefit those who cannot otherwise afford health coverage. Each state runs its own Medicaid program. An individual or family’s household income must fall below a certain amount in order to qualify. Medicare can give individuals who might otherwise not be able to afford health insurance the ability to get adequate care. Given the high cost of health care and the possibly higher cost of going without, Medicare coverage is the way to go for many.

More General Credit Information