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Does Medicare Matter

Is Medicare really necessary? This may be something you have asked in the past.


If you don't know anything about Medicare, just ask any one of the millions of senior Americans who depend on it for their health care. This is the time they need it most and without it, they would be in dire straits.


It is critical that every older American has access to a health care program that takes care of their medical needs in their 'golden' years. Keep this in mind: you will need Medicare someday and you will be grateful there is such a program.


Medicare is essential to not only the older citizens, but also to the more than 8 million disabled people living in this country. Without it these people would have nowhere to turn. Even if you have a substantial income, sooner or later, you will enrol in Medicare.


Because the government takes care of the elderly and disabled the younger generation do not have to carry the burden as loved ones get older or sick. It eases the financial burden on them and ensures their parents and loved ones are taken care of health-wise.


Unfortunately, the cost of health care is rising steadily as Medicare struggles to insure many more people. The future of Medicare is unknown and the government must find a way to guarantee that every single American will be covered when the time arises.


People who rely on Medicare are going to find challenging issues to face should the future remain uncertain, and those who are approaching Medicare age will be sorely affected as well. So yes, Medicare really matters.


People who are covered by Medicare are called beneficiaries, and Medicare covers their medical expenses, but not every bit of it. Acute conditions are covered if the patient is expected to make a recovery, but unfortunately it does not usually cover at-home care. There are also gaps in prescription coverage for patients who have a chronic disability or long term illnesses.


To our knowledge, medicare does not cover private treatment for issues like addiction, private addiction clinics, or alcohol rehab facilities.


Even so, Medicare is essential and the future would be far gloomier for Americans without it. Yes, there are drawbacks and disadvantages but one has to take the good with the bad when it comes to Medicare coverage.


Now is the time to decide what type of coverage you are going to want once you turn 65. You must also keep in mind that Medicare supplemental policies also consider the previous state of your health. Be prepared to answer health questions about pre-existing conditions that may be a deterrent to you getting supplemental coverage.


So, in the end of it all Medicare is a necessary program no matter how you look at it. Whether it ends up being run by the Federal government or by individual states, you still have to have this program whether you like it or not. It is one of the things in life that can be counted on. As you draw closer to 65, you will (or should) begin to realize that Medicare can be a life-saver.



Medicare Options for You

If you have a 65th birthday coming up soon you probably have questions concerning Medicare and the coverage, benefits, and options available to you. Questions about when to apply, what is covered, how much is it going to cost and many more are probably running through your mind. You may have even heard horror stories from people who have already dealt with the complexities of the Medicare program and are wondering if this will happen to you. You may also wonder what it will mean to your eligibility if you already have health insurance. Do you drop it? Keep it? Will your benefits be reduced or your options fewer?


As you undoubtedly already know or have heard Medicare consists of 4 'parts'-A,B,C,and D. A simple breakdown may help you further understand this program.


Part A: is known as the “original” Medicare, and pays your hospital stay should the need arise, but be aware that it doesn't cover all costs associated with your hospitalization.

Part B: (also part of the “original” Medicare plan) will pay for your doctor visits. You must keep in mind that neither Part A or Part B will cover things like dental, vision, hearing or drugs you may need.


Part C: this is what you will need to cover additional costs. Private insurance companies will provide a plan for you that provide all the benefits of Parts A and B, pay for your prescription drugs and depending on what plan you choose, may also pay for hearing, dental, and vision. Choose a Part D plan that will give you the coverage you need at a cost you can afford.

Part D: this is a plan in itself that you can enroll in to cover just your prescription drugs. It is a separate “stand alone” plan for drugs only.


Also remember there is a deductible for Part A that you are required to meet yearly before it kicks in and pays your hospital stay, and there are certain things that it does not pay for regardless, such as the doctor services or personal costs. Part B deductible premiums are yearly and are taken out of your Social Security check automatically.


If you have private health insurance Part B will pay 80% and your own insurance will pick up the remaining 20%, but you have to pay your deductible. Medicare isn't as complicated as it seems to be at first. Once you understand the different Parts they are not going to be as complex as you anticipated.


Medigap (a medical supplement insurance plan) is something offered by a private insurance company that helps pay for things that A and B don't. The better the plan however the more it is going to cost you.


Consider the state of your health before making any choices. If you are not taking prescription drugs, are relatively healthy, or just have basic checkups with your doctor once or twice a year, make sure you choose a plan that suits these needs. You can always get additional coverage if your situation changes. There is no reason to spend money on a coverage you won't use that often.


Go to a website that can offer information and answer questions you have. Start with the official Social Security site that has answers to most of the questions and a wealth of interesting and informative material pertaining to Medicare.



Medicare on the Horizon?

There isn't anything about Medicare that isn't confusing at one time or another. The minute you reach the age where Medicare is looming on the horizon you will without a doubt have questions you need answered.


Chances are your mailbox will be flooded with pamphlets, brochures, and other other materials concerning this subject. What do you do, and where do you find the information you need and can easily understand for the questions you have? What is Medicare, and what does it mean for you?


First of all it would be good to start out by explaining the basic information about Medicare. This is a bill that was instituted in 1965 to establish health care for the elderly and disabled citizens of the United States. Most of the confusion surrounding Medicare has to do with the 3 parts the program contains. This is where many people have difficulty understanding the concepts of each part.

Part A pertains to hospitalization coverage, Part B are your doctor visits, and lastly Part D, which is your prescription medicine coverage. Do you need all three parts, just one or two, or none at all? Questions abound in the Medicare world.


Let's take a closer look at Part A-your hospitalization coverage. Most people will have no monthly fees for this part-essentially Part A is free when you sign up for Medicare. If you are a patient in the hospital, require critical care or skilled nursing access you are required to pay nothing.


Of course this doesn't take into account the deductible you are required to pay each year for your hospitalization stay, and this amount is subject to change from year to year. After your deductible has been met Medicare will pay 80% of your cost. This means that the remaining amount, or 20%, will be your responsibility. Part A is actually the easiest part of Medicare to understand.


Medicare part B is what pays for your doctor visits. You may need to enroll in Part B and there are a couple of ways to do it: General Enrollment vs. Special Enrollment. Each year beginning in January open enrollment is available to the public through March of the same year. This is the only time you will be able to use this option. There is a form called HCFA-40b that you will have to fill out and you can get one at any Social Security office. They will be happy to mail you one if you call.


Be aware that your Part B coverage will not go into effect until July 1st of that year however. The Special Enrollment is available any time of the year if you are a qualified beneficiary, and coverage begins immediately with no waiting period. The package is available from the Social Security office. There are stipulations that will be explained in full in the package guidelines.


Medicare is confusing enough without adding Part D, or prescription coverage, into the mix - then came along the Medicare Modernization Act in 2003. Basically Medicare Part D is a joining of Medicare and most private insurance companies that will cover your prescriptions drugs.


You will need to choose a company that has a provider in your locale. You will have an annual deductible amount each year, and have to pay a monthly premium in addition to this amount. Once you have met your deductible 75% of your cost is absorbed by Medicare. For more detailed and in depth information visit your Social Security office or go online to learn more.



Medicare Eligibility Requirements

Anyone who is 65 or older is eligible for Medicare in the United States. The person must have resided in the US for at least 5 years consecutively. If you are younger than 65 but have a disability (qualifying) you are also eligible to receive Medicare. A person who suffers from end-stage renal failure can be eligible at any age.


There are certain times of the year when you can enroll in the Medicare program, and each enrollment period has a specific purpose.( If you have worked for a period of at least 10 years you will usually automatically get part A for free, providing you have paid Medicare taxes.) You will have to pay a monthly premium on your Part B, however.


IEP, or Initial Enrollment Period is the is when you first become eligible. The timing of the IEP and the date you will turn 65 will determine when you may enroll for Medicare. If a disability occurs before you turn 65 then the IEP will be based on the date you became disabled. January 1 to March 31st of each calendar year is the time designated for a GEP, or General Enrollment Period. If you did not enroll during the EIP, this is the time you would enroll.

If you meet certain requirements and you missed the IEP, you may be allowed to enroll during a Special Enrollment Period, or SEP. Perhaps you missed the EIP or just decided not to at that time. You must be a new beneficiary to qualify for the SEP.


The MSOEP, or Medicare Supplement Open Enrollment Period is a good time to you to add or enroll in a Medicare supplement program. If you are already enrolled in Parts A and B this is the perfect time to get your supplemental plan.


The first month you actually turn 65 is when you are able to enroll. During this time frame you are allowed (and guaranteed) the right to buy any plan you wish being offered in your state no matter what the status of your health or any prior health issues you may have.


This part of Medicare is known as Part C, which would be delivered through a private insurance company you have chosen.


If you receive benefits from the Railroad Retirement Board your enrollment will be automatic. Other than this, unless you are already receiving Social Security Benefits you will not be notified that you are eligible for Medicare. It is up to you to contact a Social Security office for the information you need to enroll.


Doing this a few months before your birthday is advantageous to you so that you will receive your Medicare benefits on time. It is not a good idea to delay enrolling in Medicare because you will also be delaying the benefits you worked so hard for and are rightfully yours. If you are approaching 65 get in touch with your Social Security Office to determine exactly what you have to do.


They will also be able to answer any questions you have and help you navigate the complexities of Medicare policies.


Medicare Benefits Vary from State to State

In a perfect world, it would make sense for Medicare to be the same from state to state but unfortunately (or fortunately-depending on which state you reside in) this is not the case.


Each state has different rules about who gets what and the conditions attached to each rule. So, before you decide to relocate-if you get Medicare now, make sure you understand the rules of the state you move to concerning Medicare. Check with your Social Security office so you are fully informed about what changes to expect.


The similarities from state to state concerning Medicare regulations and rules are general, and you certainly don't need to think you will lose your Medicare or have to reapply again. If you are moving to Massachusetts, Wisconsin, or Minnesota you will need to know that these states have their own system concerning health care.


Although similar to Medicare these states take on everything internally. This type of program in the three states is pretty new so find out what you can before heading to one of the three on a permanent basis.


When comparing a State- run Medicare plan to a Federal program is still up for debate. There have been a great many arguments between people on one side or another, and while each side has valid points it is up to the individual to choose what suits his or her circumstances. As long as the chosen system benefits you and your needs this is pretty much all you have to think about.


The best way to find out about Medicare benefits and how they differ is to check your state versus other states at a website that is dedicated to this particular subject.


When a state-mandated Medicare program or a government run Medicare health plan is arguable it comes down to one key point-the consumer is the one going to bear the brunt of the decision. The argument between the House and the Senate is long-standing , with neither side willing to come to terms.


The House favors the Federal government run program stating that individual consumers will be better protected with a uniform program. The Senate, on the other hand would like to see the exchange implemented and run by each state. They seem to feel that the state has more experience dealing with insurance plans and a better idea of what the residents need.


When comparing the final cost to the consumer no one is going to come out ahead of the game no matter what type of decision is finally made between the two. Whether State run or Federal run, the individual is still going to end up paying out money to insurance programs for the coverage they choose.


It may be a very good idea for you to visit websites that have this type of information to keep yourself abreast of what may be happening, because in the long run you, and your Medicare benefits are what will be affected the most.