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Getting to know the Basics of Medicare

Medicare has become a major part of the American way since being legislated in 1965. Medicare is typically for people over the age of 65, but also covers American’s under the age of 65 if they meet certain criteria. It is growing rapidly, increasing over 1.7 million enrolled from 2006 to 2008.

Medicare has many different plans to choose from depending on your health and what you need that will benefit you. Medicare has been known to be a righteous resource for older Americans over all the years, because it provides the healthcare needed for those individuals who aren’t in a position to afford other costly insurance.

Four Important Basic Components of Medicare

A: Hospital Insurance for Inpatients

Part A usually places qualified applicants right away, and with this they aren’t charged a premium. This type of Medicare is typically for patients that are admitted to the hospital where the doctors and the nurses are there to help 24 hours a day. Other benefits to part A is if a person is placed in the care of hospice where they stay is short term.

B: Physicians Insurance for Outpatients

To register for Part B you would go to your local Social Security office and pay a percentage which is usually based on how much and individual makes on a yearly basis. These services include any type of testing done while visiting a facility, visits to your family doctor, and or any treatments that you may endure while visiting the hospital. Patients are typically responsible to pay 20% and the Medicaid will cover the other 80%.

C: The Advantage Plan

This plan is similar to part A and B but are offered by your own private insurance company as long as Medicare accepts them. Typically the plan will give the patient and list of appropriate doctors. This plan will include outpatients as well as Inpatients.

With this plan costs can differ a great deal depending on the Physician and or the facility. Typically Medicare will only allow you to use Physicians from the given list otherwise your visit may not be covered. Vision and Dental coverage can also be included in the plan but will cost extra. This plan will not cover any time at a hospice unlike plan A and B.

D: Coverage for Prescription Drugs

This type of coverage is also provided by outside insurance companies, and is completely optional. There are different costs when dealing with each prescription drug plan, and will also cover different drugs. When choosing a plan you always want to be cautious and make sure that the pharmacy that you use is one that is approved by the plan, as well as being aware of what prescriptions the plan covers.

Choosing this plan could help to reduce your cost of prescriptions in the future, but may not lower what you are paying for your current prescription drugs. There are also other costs when choosing these supplemental plans that can vary depending upon which plan you choose.

The Original Plan

Those who qualify for Medicare are termed recipients. A recipient could go to suppliers, doctors, hospitals, and other places that take Medicare and are admitting new Medicare patients.

Recipients will be held accountable for paying coinsurance and deductibles for the majority of services.

  • Deductible – This is the total that a recipient will have to pay prior to Medicare activating payment for the services that are included in the plan.
  • Coinsurance – This is the portion the recipient will have to pay once the deductible is reached, typically around 20 percent.

To aid in paying for some of these costs recipients could opt to buy additional Medicare coverage in the form of the Medigap plan, or the Part D plan that helps with prescription coverage.


Medigap plans or additional Medicare plans are obtained by private companies to assist recipients with the out-of-pocket expenses. In order to qualify for a Medigap plan a recipient must be enrolled in Medicare Parts A and B.

Additionally, if a recipient has the Original Medicare Plan as well as a Medigap plan, each will take care of their portion of the health care expenses that are covered.

When choosing health care it is vital to pick the plan that works best for you and your needs, keeping in mind your current situation as well as health care coverage for the future.  Also remember that the time you cannot be denied coverage on a medigap plan is during your Medigap Open Enrollment Period.  Click the link to learn more.