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Medicare 101

Posted Feb 24th, 2012 by Patient Assistance Team

You may here the name a lot in the news, but for most individuals, understanding the basic tenets and specific guidelines of Medicare is a quagmire.

So exactly what is Medicare?

Medicare is health insurance for essentially three groups of individuals:

  • People 65 or older
  • People under 65 with certain disabilities
  • People of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure that may require dialysis or a kidney transplant)
  • In addition to qualifying for Medicare, the federal insurance program also contains a number of benefits and usually, this is where it gets tricky in trying to filter out what you may really be eligible for with Medicare. Just like there are three groups of individuals who qualify for Medicare, there are four different parts to your coverage:

    Part A covers hospitals visits, inpatient care and home-health or hospice care.

    Part B covers services, outpatient care, durable medical equipment, and home health care and it also helps cover some preventive services to help maintain your health and to prevent certain illnesses from becoming more serious.

    Part C, also known as Medicare Advantage, covers private health insurance plans run by Medicare-approved private insurance companies.

    Finally, Part D is Medicare prescription program, which helps to lower the cost of prescription medications. It is run by private insurance companies, so in order to get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each private plans can vary in cost and drugs covered.

    Since understanding Medicare can be very confusing, there is fortunately a lot of support services out there to help you better comprehend the program. Local and community health advocates, the Internet and even your own medical provider and pharmacist can help you become clearer on the basics and details of Medicare.