Medicare is a subsidized health care insurance program given by the U.S government, including people age 65 or above, younger who meet specific eligibility criteria, and individuals suffering from particular diseases.
History
36th American president Lyndon B. Johnson signed a bill into law on July 30, 1965, that helped initiate both Medicare and Medicaid.
Medicare Vs Private Health Insurance
The only common point between Medicare and private insurance is that both cover costs for eligible individuals.
The essential part of Medicare is free of premium, whereas Medicare’s coverage is limited compared to private health insurance. Private health insurance has a wide range of coverage extending to the next generation like your spouse and children, but this is not the case with Medicare. People have to qualify for the criteria on their own for Medicare coverage.
Difference Between Medicare And Medicaid
Medicare and Medicaid are government-funded insurance programs, but both programs have different eligibility criteria. Medicare is designed for people age 65 or above and younger people with certain special conditions, but Medicaid is a joint federal and state program designed for low-income people. One should have a limited amount of liquid assets to qualify for Medicaid.
Currently, the Centers for Medicare and Medicaid Services (CMS) is leading this program, and it has included people suffering from end-stage renal disease and amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease, by extending its services.
Parts Of Medicare
There are four different parts of Medicare. Each element carries various services for the insured person.
- Medicare Part A
- Medicare Part B
- Medicare Part C
- Medicare Part D
Medicare A
It covers costs billed by hospitals or inpatient-like settings i-e skilled nursing facilities, home-based healthcare etc. This plan does not give long-term care. Coverage of Medicare part A is automatic for everyone who holds social security benefits. Enrolment of the people not receiving security benefits can be done through the SSA website.
Medicare Part B
It covers costs for outpatient care such as doctor visits, preventive services, ambulance services, specific medical equipment, and mental health coverage. Some particular drugs prescribed are also part of his plan.
Medicare Part C
The eligibility criteria for Medicare C are the same as for Medicare A and Medicare B. It is also called Medicare Advantage. Consumers get these plans via private insurers rather than through the government itself. Medicare Part C must give coverage equivalent to Medicare Parts A and B.
These plans may also include other facilities that may not be possible for the original projects or have to buy through additional supplemental insurance, i-e, the Medigap plan. These plans may also include co-pays, co-insurance, deductibles, and even costs related to insurance while travelling outside the U.S.
Some Medicare Advantage plans already facilitate covering hearing services as additional benefits. Those hearing services that basic Medicare does not currently provide would be provided until 2023 as part of the Build Back Better plan.
Medicare Part D
This part includes additional prescription drug coverage in Medicare. People enrolled in Medicare part A or part B have to register in part D to get a subsidy on drug costs that original Medicare plans are not providing.
Rules For Contacting An Agent
There are specific rules and regulations to keep in mind while approaching an insurance agent.
The agent should follow the rules and regulations required, which are as follows.
1. Medicare staff and Medicare plans can offer you the following details during the meeting.
2. Material of the plan
3. Guide you about plan options and ways to get further plan info.
4. Provide you with an enrollment form
5. Collect the completed enrollment form from you.
6. Give business cards to your friends and family.
Medicare staff and insurance plans are not permitted to offer the following things.
1. They cannot charge you a fee for enrolment.
2. They cannot drag you into a particular plan.
3. They cannot give incorrect information about their plan.
4. They cannot use statements like their plan is highest ranked for publicity purposes.
5. They cannot force you to join any plan you are unwilling to enter.
6. They have to offer the plan that you are interested in.
7. They cannot ask for your friends and family’s addresses and contact numbers to sell insurance.
8. They cannot ask you to sign the form before you are willing to do it by your heart.
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