For the people of age 65 or above, the federal government offers a health insurance, known as Medicare health insurance program. The health insurance is not restricted to the age limit- with certain conditions being fulfilled, the younger people are also offered this health insurance by the government. Conditions like, people suffering from end-stage renal disease, the permanent kidney failure or the need for the process of dialysis regularly or people who need a transplant- it is also called, ESRD. Medicare offers various plans and parts to the people. Every part or plan features different services, so people can choose from them according to their needs and requirements. To learn about these parts and plans, people can also look for Medicare for dummies.
Medicare Health Plans
The Medicare health plans are offered by a private company that has an active contract with Medicare in order to provide the advantages of Part A and Part B to the public, who is enrolled in the plan. The Medicare Advantage plans, Medicare cost plans, and Demonstration or Pilot Programs are all included in Medicare health plans. The special kind of Medicare health plan is Program of All-Inclusive Care for the Elderly (PACE) organizations. Public or private both entities are able to offer Program of All-Inclusive Care for the Elderly plans. Also, they can provide the drug plans (part D) and other advantages other than part A and part B benefits. These plans and more are explained thoroughly in Medicare for dummies.
Medicare health plans serve for the Medicare Advantage plans, Medicare Medical Savings Account Plans, and some other Medicare health plans. Some other health plans include Medicare Cost plans, Pilot or Demonstration Programs, PACE and Medication Therapy Management (MTM) programs that are needed for complicated health requirements.
Medicare Advantage Plans
Medicare advantage plans cover for all the services that are covered by the original Medicare. There certain coverages that are provided by the original Medicare, even if the person is enrolled in Medicare Advantage plans. They are; the cost coverage of hospice care, certain new Medicare advantages, and particular amount for the clinical research studies. All types of Medicare advantage plans always cover for the medical emergency and care services that are required urgently. Medicare allows the plan to be able to choose if the particular service needs cost coverage or not (if the service is not medically required). If the person is not sure that a certain service is covered, they can check it with their provider, before they redeem that particular service. A number of Medicare advantage plans offers to cover for extra health care services such as dental, wellness programs, vision, hearing, and health programs. Most of the Medicare Advantage plans offer the cost coverage for prescription drugs- part D of Medicare. The person has to pay an additional amount (monthly premium) for the Medicare Advantage plans, to the Part B premium.
The generalized premium amount for part B is $134 in 2017– which can be higher, depending on the person’s income. The amount is more likely to remain the same in 2018 as well. Some people might pay lesser than $134 because they have Social Security advantages. Their payable amount in 2017 is $109, but it is more likely to increase up to $130 in 2018, on average. If a person requires a particular service, which is decided as not medically required by the plan, the person will have to pay all the cost of the service. However, they still have the right to appeal in their favor. People can also ask for the plan to provide them a particular service (in written) in order to be sure that the service is medically required and will be covered by the plan. If the person has not asked for an advance coverage decision, they will have to pay the costs for the service, in case the plan refused to pay for it.
Medicare Medical Saving Account Plans
Medicare collaborates with some private insurance companies in order to order to offer the people different ways to redeem their health care coverage. These companies are capable of choosing to give consumer-directed, Medicare advantage plan to the people. It is known as Medicare Medical Savings Account Plan. Health saving account plans that are offered outside of the Medicare are quite similar to these plans. People can choose their own health care services that they require and their own health care providers.
Medicare Medical Savings Account Plan offers its two different parts to the people. This plan combines the two plans, in order for the people to pay for their health care services’ costs. They are; high deductible insurance plan and Medical Savings Account Plan.
The high-deductible health insurance plan is a special variation of Medicare Advantage plan (Part C). Once the person has reached a high yearly deductible, the plan will start to cover their costs. This also varies, as the plan does.
The medical savings account plan is a special variation of savings account. The Medicare medical savings account plan is responsible for depositing the money into the person’s account. The person is able to choose to pay for their health care services’ costs with the money before they reach the deductible.
There is coverage for certain health care services apart from the Medicare services that must be covered by all the Medicare Advantage Plans. These services can be covered at an extra cost. The services include; vision, dental and long-term care- which is not covered by the Medicare health insurance. Medicare medical savings account plan does not cover the Medicare Part D (prescription drugs). If the person needs the drug coverage and has joined Medicare Medical Savings account plan, they need to join Medicare Prescription Drug Plan as well.
Medicare Cost Plans
Medicare cost plans are a variation of Medicare health plan, which is available in particular areas of the county. A person is able to join the Medicare cost plan, even if they only have Part A or Part B. people can join the plan anytime, it has an opening for new members. A person is able to leave or return any time to the Original Medicare. If Medicare prescription drug coverage is offered by the plan, people can get it from them and if not, they can buy Medicare Prescription Drug Plan (Part D).
People can look for Medicare for Dummies to navigate through the plans and when they need help in deciding which one is best for them.