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Medicare Can Be Confusing

That’s why we’re here. We specialize in the senior market, and our insurance agents will make obtaining your benefits stress-free. We are here to help you understand which health plan is best for your needs.

If you live in the United States and are over the age 65 or permanently disabled, you may be eligible for Medicare coverage. Medicare is a federal health insurance program that provides medical benefits to specific groups, such as seniors and those with disabilities.

Though the name is similar, it should not be confused with Medicaid, a health coverage program available to low-income individuals and families. It may seem difficult at first to tell these two programs apart. However, one key difference should be noted. While the requirements to be eligible for Medicaid are strictly defined, any U.S. citizen over 65 has access to Medicare.

Common Medicare Questions

What is Medicare?

Medicare provides health care coverage to residents of the United States, who are 65 years of age or older, and people with specific disabilities. It is not related to income; instead, it relies on the taxes people pay during their careers. The federal government oversees the Medicare program, so there is less variation between states than with Medicaid.

Medicare coverage functions similarly to many private healthcare insurance options. It will pay a portion of the beneficiary’s medical cost while expecting a deductible and co-pay from the beneficiary. Unlike private healthcare insurance options, however, a person and their spouse will have to enroll separately as Medicare can only provide for one person at a time.

Who Administers Medicare?

The four parts of the program are administered slightly differently. You enroll in each one separately – or bundle them through Part C.

When enrolled in Part A and Part B, this is known as Traditional or Original Medicare. The federal government administers this program.

Part C is known as a Medicare Advantage Plan. It bundles Part A, Part B, and Part D services. Part C is administered by government-approved private insurance companies and regulated by the federal government.

Part D provides Medicare drug coverage. This coverage is optional but is available to everyone who has traditional coverage. Part C doesn’t require a separate drug plan. Private insurance companies administer part D.

Who is Eligible for Medicare?

Anyone who is a United States citizen is eligible for Medicare within the first month of turning 65. For those receiving Social Security or Railroad Retirement disability benefits, Medicare is available after 25 months of receiving those benefits, except for those with ALS. They become eligible as soon as they receive Social Security disability benefits. Those with End Stage Renal Disease will become eligible on the first day of the third month of receiving renal dialysis treatments.

Medicare Is Split Into Four Parts:

Part A

Covers hospital services and inpatient care in skilled nursing facilities, hospitals, home healthcare settings, and hospice.

Part B

Covers outpatient care, including provider services, home health care, ambulance services, therapeutic/rehabilitation services, mental health services, durable health care equipment like oxygen tanks and wheelchairs, and prescription drugs that a physician typically administers.

Part C

Part C is an alternative way to receive your Medicare benefits. It is also called Medicare Advantage.

Part D

Covers outpatient prescription drugs that you would pick up at a pharmacy.

A hassle-free way to learn about Medicare benefits?

Imagine that.

We go above and beyond to help you find the plan that works best for your needs because it’s what you deserve. Get your free, no-obligation quote to see how Elite Insurance Group can help you get the most out of your Medicaid benefits.

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