Enrolling in Medicare Can be Complicated
Medicare has been present since the late 1960s and is administered by the US federal government. In recent years, around thirty to fifty private insurance companies all over the United States are under contract with Medicare.
The United States Medicare is financed through surtaxes and premiums from beneficiaries, overall revenue, and payroll taxes. What’s so great about Medicare is that it gives Americans that are aged sixty-five and older that chance of having a health insurance.
Medicare provisions are not only limited to older Americans, but it also extends to young people with amyotrophic lateral sclerosis, end-stage renal disease, and those with some sort of disability as per the Social Security Administration.
Over fifty-five million beneficiaries enrolled in health insurance by Medicare back in the year 2015. Medicare can cover a percentage of a person’s health care expenses.
Individuals will pay the remaining percentage of their health care expense that isn’t covered by Medicare. You can pay it by using a separate insurance, supplemental insurance, or if you simply have cash on hand. Medicare coverage may vary, so the health care expenses that are not covered will also depend on it.
For example, the individual’s expense might include eye, ear, dental, or long-term care as well as additional insurance premiums.
Currently, a number of people who are enrolled in Part B are expressing concerns regarding the enrollment process. The people are requesting for the Congress to help them be informed on when and how they are to enroll in Medicare.
If you get one thing wrong in the enrollment procedure, you will have to pay expensive penalties for the gaps in health coverage. A bipartisan bill was recently reintroduced in Congress that could help in improving the enrollment process of Part B by give information to the individuals, and minimize or eliminate the gaps in the coverage during enrollment periods.
If the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act is implemented, this will allow the enrollment procedure to be modernized.
Individuals who receive Social Security benefits are automatically enrolled in Part B however, since numerous Americans are working overtime, delaying retirements and benefits, a lot of them now are paying a lifetime of higher premiums and are possibly going about without the needed care.
Two medical insurance plans are sponsored by the government; Medicare and Medicaid.
In Medicare, there are four parts that have their own benefits.
Part A: Hospital or Hospice Insurance
If you are admitted as an inpatient, then Medicare will cover semi-private rooms, the various tests, and hospital food. You can only stay as an inpatient in the hospital for a maximum of ninety days. The first sixty days is fully paid by Medicare while the remaining days should be co-paid.
Reimbursement for other health care expenses can be made under Part A. The time that you spend in the hospital before you get admitted as an inpatient will fall under Part B since that will label you were still there as an outpatient.
If a patient is admitted to the hospital again after thirty days, Medicare can penalize these hospitals for the readmission. Medicare will take back the initial payments for the hospital stays with an addition of four to eighteen times the initial fee.
Provisions for terminally ill individuals with less than six months to live are also provided. Hospice is 100 percent covered with no deductibles or no co-pay, but outpatient medicines and respite care are the patient’s responsibility.
Part B: Medical Insurance
Part B is responsible for outpatient individuals. This is optional and can only be used if the beneficiary or the spouse is not working or if there isn’t a health coverage being provided by the employer. You will receive a lifetime penalty of ten percent per year if you don’t get yourself enrolled.
Medicare pays eighteen percent while the individual pays twenty percent. Part B covers some illnesses and outpatient medical treatments. You can find information on the Medicare Part B premiums for 2018 here.
Part C: Medicare Advantage Plans
A typical Plan C has health maintenance organization that needs the individual to have a primary care physician, and they also need to pay monthly premium as well as additional payments in Part B premium to cover items that are not included in Part A and B.
Part D: Prescription Drug Plans
Part D mostly covers self-administered drugs and anyone either enrolled in Part A or B is eligible. You can receive this benefit if a person with Medicare is also enrolled in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan that includes prescription drug coverage.
Are You Eligible?
All persons who are sixty-five years old and above and are legal residents of the United States for at least five years can be eligible for Medicare.
Younger individuals who have disabilities are also eligible as long as they receive Social Security Disability Insurance (SSDI) benefits.
There are also specific medical conditions that can help you become eligible for Medicare.