Medicare has a long history in the United States. It became a federal government program when President Lyndon Johnson signed it into law in 1965.
Since then, the healthcare program has served millions of people. As of 2019, the total number of program subscribers topped 61 million.
Though Medicare has been around for nearly six decades, there are still some common misunderstandings about the plan and what it does. For more information, here are the 3 most asked questions about Medicare.
The terms Medicare and Medicaid are commonly mixed up. Though they serve similar purposes, who they deal with and what services they offer are different.
Medicare is a government-based insurance program run by the federal Centers for Medicare & Medicaid Services (CMS). Its primary goal is to serve people over 65 as well as younger individuals with disabilities.
Depending on the type of Medicare (there are several parts), patients pay a minimum deductible for appointments and hospital stays.
Though it’s a national program, Medicare is handled by several third-party organizations. For instance, an individual could contact an Omaha Insurance Medicare Agent to establish service.
Once a connection is established, the company representative works with the potential customer to address their health and economic means as well as complete the Medicare paperwork.
On the other hand, Medicaid is jointly supported by both federal and state governments. Whatever the latter spends the former matches.
Furthermore, because it serves low-income individuals regardless of age, the patients pay little or nothing for their medical expenses. At most, they may need a co-payment of a few dollars.
Though there aren’t different types of Medicare the program is separated into four parts. This is a result of when they were enacted by the U.S. government. Additionally, each part covers a different aspect of medical care.
The initial version of Medicare had two parts. There is Part A for inpatient/hospital coverage and Part B for outpatient treatments.
These original components don’t require patients to get prior authorization from Medicare to get treated. Additionally, a monthly premium is required for Part B along with some form of coinsurance.
Part C, established in 1997 as part of the Balanced Budget Act, opened Medicare to contract with public organizations to offer a variety of health plan options similar to those in the commercial marketplace.
For instance, the program became part of HMOs, PPO, and Medical Savings Accounts (MSAs). The plans under Part C provide all the benefits of Parts A & B as well as additional offerings.
Part D went into effect in 2006. This improvement expanded Medicare to include an optional prescription drug benefit. Through Part D, subscribers have the option to pay reduced costs on their medicines through the programs established in Parts A-C.
There are two ways to sign up for Medicare. The first is through automatic enrollment. This occurs when people apply for either retirement or disability benefits from the Social Security Administration. This application doubles as enrollment to Part A Medicare.
If a person doesn’t receive retirement or disability benefits via Social Security, then they enroll in Medicare through a public or private third-party organization. Here, representatives work with clients to complete the proper materials to get into Part A of the program.
In either case, there’s a seven-month enrollment period where a person must sign up for Medicare Part A & B. This is three months before or after they turn 65 and the month of their birthday.
If this enrollment period is missed, then the individual may need to wait to register. At this time, a late penalty could be applied.
Needless to say, Medicare has many moving pieces. Therefore, it’s a good idea to obtain as much information as possible about the program before the enrollment period.
Rather than waiting until the last minute, speak with a representative at the federal or private level to request a handbook.
Get your questions answered as to the different parts and how Medicare could be part of an HMO or PPO plan. Overall, subscribers will feel more secure about their choices if they have the right answers on hand.