Learn the Basics

The ABC’s of Medicare

Medicare is a national health insurance program created in 1965 to help cover medical expenses for Americans age 65 or older. You are entitled to Medicare Part A if you or your spouse are eligible for Social Security payments and have made payroll tax contributions for 10 or more years. Medicare was expanded in 1972 to include people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or kidney transplant).

Medicare is made up of 4 parts.

Part A is hospital insurance.

Part A covers inpatient hospital stays, care in a skilled nursing facility, and provides limited benefits for home-health visits and hospice care. Although the Part A premium is free for eligible individuals, you are still required to pay a deductible for inpatient hospital care. In addition, you must pay daily copayments for long stays in hospitals and skilled nursing facilities.

Source: Medpac Report to Congress: Medicare and the Health Care Delivery System, June 2012

Part B is medical insurance.

Part B covers doctor visits, outpatient hospital care and other medical services not covered by Part A. As a Medicare beneficiary you would be responsible for paying a deductible, as well as 20% of the allowable charges for most services, except for home health, clinical laboratory and certain preventive services.

Source: Kaiser Family Foundation Fact Sheet

Part C or Medicare Advantage is an optional policy.

Offers health plan options run by Medicare-approved private insurance companies. Part C includes all benefits and services covered under Part A and Part B. Most Medicare Advantage Plans cover Medicare prescription drug coverage (Part D) as part of the plan. Some may include extra benefits and services for an extra cost.

Source: www.medicare.gov