What Does Medicare Cover? Am I Automatically Enrolled in All Parts of Medicare Health Insurance Coverage?
What is Medicare?
Medicare health insurance coverage is one of the most commonly used types of health insurance. Medicare is a health insurance program that is run by the federal government and it covers Americans who are age sixty-five or older. Medicare coverage has four parts, A, B, D, and C. Some disabled people younger than age sixty-five can qualify for Medicare coverage.
What Does Medicare Cover?
Medicare Part A provides hospital insurance coverage. This part pays for in-patient care in a hospital, skilled nursing health services, durable medical equipment, home healthcare services, and end of life hospice care. A Retiree who is eligible for Social Security is automatically eligible for Medicare Part A, because the premiums were paid by the retiree when he was working. Premiums for Part A were withheld from a retiree’s pay by his employer along with social security tax.
Medicare Part B is called medical insurance coverage. This part covers doctor’s services, medical laboratory tests, hospital outpatient care, physical therapy, and occupational therapy. A retiree does not automatically receive Part B benefits. Retirees need to enroll in Part B if they want it. Part B premiums are deducted from a recipient’s Social Security check. Medicare Part B usually covers about eighty percent of a recipient’s approved charges. The remaining coinsurance and deductible are payable by the retiree. Some retirees buy private Medigap insurance to cover the Part B deductible and coinsurance that Medicare does not pay.
Part D covers a retiree’s prescription drug expenses. This coverage is optional, and a retiree will need to enroll in Part D if he wants it. Premiums for Part D are deducted from a recipient’s Social Security, just like Part B premiums. Medicare Part D is administered by contracted insurance companies for each state.
Part C is an optional Medicare coverage that is often called the Medicare Advantage Plan. Part C is administered by private health insurance companies. These private insurers cover parts A, B, and D much like an HMO. Part C providers can offer added benefits not covered my Medicare, such as dental and vision benefits. Participants in Part C need to use providers in the private insurer’s network.
This post is part of the series: Types of Health Insurance
Get some useful information about different types of health insurance. Be informed before you make important health insurance choices.