Medicare is essential for many Americans with permanent disabilities, over 65, or experiencing end-stage disease. It covers some medical care costs, although beneficiaries often need to pay co-insurance and deductibles. Whether you’re new to the program or simply want to understand it better, here’s everything you need to know about Medicare.
Medicare Defined
Medicare is a national insurance program for individuals who are older, permanently disabled, or with end-stage illnesses. Unlike welfare programs, eligibility, and payment, Medicare is consistent state-wide and isn’t determined by income or assets. It consists of two main components: Part A and Part B.
Part A Coverage
Part A covers hospice care, nursing facility care, inpatient hospital care, and in-home health care. It receives financing through federal payroll taxes paid into Social Security by employers and employees. This form of coverage provides services that will make you or your loved one more comfortable and remove the stress of navigating the world of private insurance.
Part B Coverage
Part B differs slightly from Part A, as it covers doctor and medical practitioner services, home health care, durable medical equipment, certain outpatient care, and home health services. Monthly premiums paid by Medicare beneficiaries and general revenues from the federal government cover this part of the program.
Medicare Eligibility
Eligibility is determined by several factors, such as being over 65. Additionally, if you’re receiving railroad retirement benefits, living with end-stage renal disease, or have ALS, you can likely participate in Medicare. If you’re a federal, state, or local government employee and not eligible for Social Security retirement or disability benefits, you also may be eligible.
Medicare Enrollment Process
Enrollment is initiated through an application for Social Security, which automatically triggers Parts A, and B. Part B enrollment is voluntary as it requires a monthly premium, but you can decline this part of the program. If you’re not entitled to Social Security, you can apply separately. You should enroll during the first three months of eligibility because, if you miss that window, you may incur a premium surcharge due to late enrollment.
Home Health Care
Few people want to leave home, and there are options to keep you there. Currently, 15 million people are receiving home care, and 600 million visits each year. For many, these services are the deciding factor in whether a person has to enter a facility. If you have Medicare, you’ll want to confirm whether home health care is covered under your policy.
Aid for Assisted Living Facilities
Whether it is you or a loved one, leaving home is never easy, especially for an assisted living facility. Some people need around-the-clock care, and others need additional help. Assisted living facilities cover a range and spectrum of needs, and there are plenty of options as the U.S. has 28,900 assisted living communities. By utilizing the Medicare program, you can get some independence back and live with the peace of mind that someone will be there if you fall or need help with daily tasks.
Hospice and Palliative Care
In 2020, 1.72 million eligible Medicare beneficiaries chose hospice. Entering hospice or palliative care is not an easy decision, but there comes a time when it’s necessary. During this emotional time, you and your loved ones need to know that you will receive compassionate care so you are comfortable and pain-free.
Medicare is a vital resource for many Americans. It enables you to receive medical care that you may not otherwise be able to access and covers a range of services. The program provides health care, assisted living facilities, hospice and palliative care, and more. Find out if you or your loved ones are eligible and begin enrollment today.