What is Medicare in the USA?
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What is Medicare in the USA?

By SiliconIndia   |   Monday, 19 November 2018, 12:08 Hrs
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What is Medicare in the USA?



Managed by the Centers for Medicare and Medicaid Services (CMS), Medicare is a federal health Insurance program that was initiated by Congress in 1965 to take care of a variety of healthcare expenses.



Medicare not only seeks to provide health care aid to a variety of eligible American citizens, but it also aims to waive basic healthcare expenses for the afflicted.



Social Security is, however, responsible for enrolling American citizens into Medicare. They do this by providing information with specific facts and figures that might help them to understand the benefits of the program. Similar to the requirements of Social Security, American citizens are able to engage in the work of the state and pay their taxes to attain entitlement. Thus, they enrol in the program.



Criteria of Eligibility



Those sixty-five or above, and have access to the benefits of Social Security or the Railroad Retirement Program.



Those sixty-five or above, and have a spouse who has access to the benefits of Social Security and the Railroad Retirement Program.



The disabled without any age limitations can avail it. Also, it is necessary that the disabled have had access to Social Security and its benefits of disability for about 24 months.



People below the age of 65 can only meet the criteria of the Social Security Disability Program if they have serviced the state or government as per the program’s requirements. The criteria of those sixty-five or above can be met if they have all the requirements of the Medicare employment program covered.



Parts of Medicare
Part A (Hospital Insurance)



Ranging from inpatient hospital stay to a fixed amount of time in a nursing facility, Medicare is responsible for taking care of your hospice expenses by providing you maximum health care benefits. Medicare is, therefore, responsible for waiving off 100% of your health care expenses during the first 60 days of your stay in a hospital, or for around 20 days in a reputed and categorised nursing care facility. Medicare also grants 60 ‘lifetime reserve days’ that you can use during your lifetime in an inpatient hospital set-up, that is, if you’ve stayed in the said hospital for consecutive 90 days or more.



Part B (Medical Insurance)



Part B of Medicare is responsible for taking care of your medical expenses such as visits to the doctor’s office, blood and diabetic testing supplies, and a variety of outpatient hospital care such as X-Rays or other related tests. According to Part B of Medicare, you are responsible for paying a certain amount deductible to the program at the start of each year. This will eventually be followed with a 20% deduction after every subsequent visit to the doctor’s office.



However, if your doctor is a part of Medicare, then he can request the program to take care of all of your medical expenses as well.



Part C (Medicare Advantage)



Medicare Advantage covers all parts of your Medicare insurance program, and is, therefore, outsourced through private insurance companies that are operating under the CMS. Private health insurers such as www.GoMedigap.com provide some additional healthcare benefits, such as prescription drug plan in addition to catering to Part A and B of Medicare.



The Medicare Advantage Prescription Drug plans and is then not responsible for providing dental care or aid outside the US.



Part D (Optional Prescription Drug Coverage)



Part D is exclusively entitled to attaining deductions in prescription drugs through the Medicare Advantage Prescription Drug plan. An American citizen can avail several options, such as deductions, copayments, or flat discounts on the entire drug cost through Part D of Medicare. This too is outsourced and offered by private insurers working under the CMS.



Medicare Part D also allows unprivileged American citizens to enrol in the Extra Help Program if their limited income can’t take care of their prescription expenses. The Extra Help Program can help such citizens to avail utmost healthcare by taking care of their finances by offering coinsurance, deductible monthly premiums, or copayment options.



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