The Finer Points of Medicare Eligibility

Medicare is a government-run health insurance program that offers assistance with payment for hospital care (part A) and medical care (part B). Prescription drug coverage is also available through part D. Eligibility for medicare is based on disability or age.

The first criteria for Medicare eligibility is that the applicant needs to be a citizen of the US, and they must have worked at least ten years for a job that paid into the Medicare system. This information should be readily available on your paycheck.

Eligibility extends to your spouse, meaning that if you are married to somebody who has worked for more than ten years, the eligibility extends to you as well. Additionally, you must be aged either 65, or you must have been diagnosed with a permanent disability or kidney failure.

Again, the two requirements for eligibility are that you paid into the Medicare system for at least ten years as a US citizen, and you are over 65 or have been diagnosed with a disability.

Medicare part A is the hospital insurance portion of medicare. Most people can receive part A coverage when they reach age 65. This benefit is offered without any monthly premiums being necessary. The general guidelines state that anybody who is eligible for social security is eligible for medicare part A. Some government jobs also provide medicare coverage.

Individuals under the age of 65 who have been receiving social security benefits for disability longer than 24 months are also eligible. Individuals who are going for dialysis are also covered.

Those who are eligible for part A are also eligible for part B. This is insurance that is used to cover the costs of doctor care, outpatient care, and other medical care that is not related to hospital care. Unlike part A, however, part B is not free. There is a monthly premium necessary. As of 2011, the premiums cost $96.40. For every year that part B is available but you choose not to enroll, your premium can be raised by 10%.

As with part B, anybody who is eligible for part A is also eligible for part D. Part D is used to help an individual pay for prescription drugs. Like part B, you will have to pay a premium to sign up for this plan, but unlike part B, you the plan is only provided by private health insurance companies. In addition to these plans, there are medicare supplemental insurance plans that offer additional coverage.

Peter Wendt is a writer and researcher living in Austin, Texas. He recommends you check out MedicareMall.com, a medicare supplement insurance company offering medigap insurance.

View the original article here

Turning 65 - What About Medicare?

Once a person reaches the age of availability for medicare they have many questions surrounding what it covers and even more questions about medicare supplement insurance. This is insurance provided by private companies, for a fee, that allows for gap coverage. It is a way to supplement medicare and prepare for the unexpected. The cost for medical care is high, and when something unforeseen happens, the need for gap insurance becomes critical. No one should take the chance.

Once retirement age arrives, there is no excuse for not being prepared. Of course the recent economic downturn has hurt many retirement funds, and some people never saved properly to begin with. Still, medical expenses continue to eat a huge portion of the retired person's budget, and when an emergency arrives the importance for supplemental insurance is easy to see.

It is not a concern for whether or not to invest in supplemental insurance. It is a matter of which plan to use. The good news is that here are any number of plans available. The benefits vary and the price follows as expected. Those looking to make a purchase must make certain they are well aware of their many options before making the very critical decision of which plan to pursue.

There are ten standard plans for medicare supplement insurance, also knows as Medigap insurance. Some are more expensive than others, and some are not available in certain states. Where there are unavailable plans in some states, a plan that similarly matches is generally offered. This means that even in those states an equivalent level of benefits can be obtained for a similar price.

One thing of importance to note is that the benefit these plans offer are the same from one company to the next, however the premiums are frequently very different. Understand that paying more does not equal more benefits for a given plan. Even the process of making a claim is the same. There will surely be salespeople who indicate otherwise, however the law overrides their sales pitch ever time.

On the first of January of each year, adjustments are made to the price of the premium as a result of inflation. Because the benefits through a supplemental plan follow those of medicare, the premiums for the supplemental plane will increase for this reason every year.

Prices for these plans are set in three ways. One is called attained age. In this price plan, premiums will increase due to inflation as well annually every 1, 3, or 5 years. Still, this is often the least expensive option. The next is issue age. Cost here is based on a persons age when they sign up. There are no increases in premiums other than the annual inflation adjustment. Finally, community-rated plans offer premium prices based on geographic location.

So there are many options to chose from when one reaches the age of Medicare. It is important to understand all the benefits, the rules for the state you are in, and that paying a higher premium does not include better benefits. Take the time to become well versed in your options and chose the plan that is most suited to your personal needs. If you are looking for more information on Medicare, visit this Medicare blog.

Understanding Medicare Eligibility

Comments (0)

There are two different methods in which someone eligible for Medicare can receive the programs benefits. The first is called "fee for service," sometimes also referred to as "traditional Medicare" or "Basic Medicare." With this type of coverage, a beneficiary can receive healthcare from any physician, hospital, clinic, or other provider of service who accepts Medicare patients. Medicare pays the provider a fee for each for each specific procedure rendered during the date of service. For services Medicare does not fully pay for, the patient has several choices.

Different Medicare Options.

(1)Patients may pay out of pocket.
(2)Purchase a private supplemental insurance policy, more commonly known as "medigap" coverage which is designed to pay for what Medicare does not,
(3)Purchase Medicare Part D prescription drug coverage as part of a separate Part D Insurance plan.
(4)Apply for Medicaid coverage, which is a federal program for low income people that pays almost all of the health care expenses that Medicare does not pay, Even if you do not qualify for Medicaid, you can apply for subsidized coverage of prescription drugs through Medicare Part D.

The second method that people can receive Medicare benefits is through a managed care plan, called Medicare Advantage, offered by private insurance carriers and managed care providers. These plans cover everything that traditional Medicare does, plus additional services Medicare does not cover at all. These programs also eliminate some of the copayments and deductibles required by traditional Medicare.

These managed care plans are usually provided by health maintenance organizations (HMOs) and are generally less expensive than the combination of traditional Medicare with a medigap supplemental insurance policy. However, managed care plans limit the health care providers a patient may use. And sometimes impede access to specialist by not authorizing treatment or limiting care.

Understanding your Medicare eligibility is important. Not knowing the different options available to you could mean the difference in terms of economic feasibility and also the preservation of your health. If you need assistance in researching or navigating the multitude of options available to you, please visit our website at http://www.health-insurance-buyer.com and leave your contact information. One of our licensed agents will call you at your convenience and help explain in detail what is for most a very complex subject in a way you can understand.

Carlos Diez is a senior benefits consultant for Health Insurance Buyer a referral service that refers consumers to the insurance carriers that can best fit their wants and needs. He holds life, health, and annuity licenses in 48 states and is appointed with over 88 carriers. For contact information please reach him at http://www.health-insurance-buyer.com

Article Source:http://EzineArticles.com/?expert

View the Original article