Medicare can be a challenge if you go about it alone. Trust Verus Health Partners to help you navigate the ins and outs of the system and educate you on the benefits you deserve.
Medicare is the federal government’s health insurance program. It was created in 1965 for people who are at least 65 years of age. You can be eligible for Medicare regardless of your income, medical history, and even health status. This system was put in place as a type of “universal healthcare” for our senior citizens. In 1972 it was expanded to also cover individuals under 65 who have a long term disability. Medicare is now responsible for helping over 60 million people with health care, and in some ways financial security. Medicare covers a lot of potentially expensive health care related costs. The costs include hospital visits and stays, physician visits, prescription medications, preventive services, skilled nursing facility and home health care, as well as hospice care. As of 2018 Medicare accounted for 17% of the total Federal b\Budget, and 21% of nations health spending. Medicare is administered my the Centers for Medicare and Medicaid Services (CMS).
Generally speaking, people over the age of 65 are entitled to Medicare Part A if they (or their spouse) is eligible for Social Security payments. Medicare Part A (Hospital) has a $0 premium if they have paid payroll taxes for 10 or more years. Medicare Part B (Medical) has a premium attached, and is based on income. Those who are under 65 who receive Social Security Disability Insurance (SSDI) payments generally become eligible for Medicare after two years (24 months). Those who are diagnosed with end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS) become eligible for Medicare without any waiting period.
Verus Health Partners is the preferred choice on the Space Coast for Medicare Enrollment. Our team of friendly and knowledgable agents will help you determine the right levels of coverage based on your unique situation.
In addition to those who have turned 65 and are enrolled in Medicare after retiring; many of the Medicare population have health problems. This can include a chronic or multiple chronic conditions or limitations to daily living. In 2016 32% of those on Medicare had a functional impairment. 25% stated they had fair to poor health conditions, 15% were under the age of 65, while 12% were 85 or older. Two million Medicare recipients live in a long term care facility. In 2016, 50% of people on Medicare had an income below $26,200.(kff.org/medicare)
Many of those in the Medicare system have fixed budgets on a limited income. Providing the support they need is crucial.
Medicare was designed to cover a wide variety of health services. These services include both inpatient and outpatient services, as well as physician services. Additionally prescription drugs need to be covered. There are several “parts” associated with Medicare’s structure.
Part B covers physician visits, outpatient services, preventive services, and some home health visits. Most benefits have a deductible of $198 for 2020 and coinsurance of 20%. There is no coinsurance or deductible that is charged for annual wellness visits or preventive services. These services have to be rated “A” or “B” by the U.S. Preventative Services Task Force. Examples of these services would be a prostate cancer screening or mammography.
Part C refers to the Medicare Advantage program. This program allows beneficiaries to enroll in a private health plan to help cover the costs associated with Original Medicare Parts A and B. Generally these plans are from a health maintenance organization (HMO) or preferred provider organization (PPO). Individuals receive all Medicare-covered Part A and Part B benefits and possibly Part D benefits. Enrollment in Medicare Advantage plans has grown significantly. There are more than 20 million beneficiaries enrolled in Medicare Advantage in 2018, or 34 percent of all Medicare beneficiaries.
Part D covers outpatient prescription drugs through private plans that contract with Medicare. This includes Stand Alone Prescription Drug Plans (PDP) and Medicare Advantage Plans (MAPD) with prescription drug coverage. The Part D benefit helps pay for enrollees’ drug costs while also providing coverage for very high drug costs. There is financial assistance available for beneficiaries with low incomes and modest assets (Extra Help/Low Income Subsidy (LIS)). Enrollees pay monthly premiums and cost sharing for prescriptions, with costs varying by plan.