Medicare Provider Specialist

What is Medicare?

Medicare was originally created in 1965 to provide health coverage for Americans age 65+. In 1972, the program was expanded to cover younger Americans with permanent disabilities.

The Medicare program consists of different parts, and each part is funded differently, for example, payroll taxes fund some parts, whereas others require copays.

More than 61 million Americans are covered by Medicare.

What are the different parts of Medicare?

The Medicare program is categorized into four main parts:

Part A

Part A is often called hospital insurance. Part A is devoted to covering the costs of inpatient hospital stays of at least one night, some skilled nursing facility stays, and hospice and home health care.

Part B

Part B is often called medical insurance, and it covers outpatient expenses and services, such as nursing and physician fees, X-rays and diagnostic testing, medical supplies, preventive services, renal dialysis, and certain equipment.

Part C

Part C or Medicare Advantage is the all-in-one alternative to original Medicare. Part C is usually a bundled plan compiling Parts A, B, and D. Medicare Advantage includes extra benefits like prescription drug coverage. Coverage might be limited to a specific network of providers.

Part D

Part D adds prescription drug coverage to the Original Medicare and some other Medicare plans. Part D provides price breaks on prescription drugs for around 46 million Americans. In many cases, the Part D plans are designed and administered by private health insurance companies.

Who is eligible for Medicare?

Generally, you’re eligible for Medicare if you:

• Are age 65+ and have been a legal permanent US resident for at least five continuous years
• Are under age 65 and have amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD)
• Are under 65, but you’ve been entitled to Social Security Disability benefits for a minimum of 24 months

Your HealthStone Medicare provider discusses Medicare in detail and takes time to answer your questions.

Different parts and benefits of Medicare have different requirements. For example, to get Medicare Part A without a premium, you must have paid Medicare taxes. Either you or your spouse must have worked for a minimum of 10 years before enrolling in Medicare to qualify for free coverage. For disabled children, the parent must have worked for at least 10 years. If not, you might still be eligible, but you’ll have to pay a premium for Medicare Part A.

You must understand your Medicare coverage, so you can get the most out of it and protect and improve your health. Rest assured, your Medicare provider at HealthStone Primary Care Partners is here to help. Call the office or request an appointment online today.