Reminder: December 7 is the Last Day of 2026 Medicare Open Enrollment. If you want to discuss your Medicare questions with a member of the Ieuter Insurance Group team, please make sure to reach out by December 5.
Medicare is the U.S. government’s national health insurance program, primarily designed for individuals aged 65 and older, although it also serves younger people with disabilities or certain health conditions. With rising healthcare costs, having a clear understanding of Medicare is essential for those eligible for its benefits. In this blog post, we'll explore what Medicare is, its different parts, and how you can make the most of it.
What is Medicare?
Medicare is a federal program that provides health insurance to qualifying individuals, ensuring they have access to medical care. Originally created in 1965 under President Lyndon B. Johnson, Medicare has evolved over the years and is now an essential part of the U.S. healthcare system.
Medicare can cover many of the costs associated with medical services, but it's not a one-size-fits-all solution. Medicare has Four Parts:
Medicare Part A (Hospital Insurance):
Covers: Inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
Cost: Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working. If you need to buy it, the monthly premium can be significant.
Important Note: Although Part A covers hospitalization, it doesn't cover everything. For example, you may still need to pay for deductibles, copayments, and coinsurance.
Medicare Part B (Medical Insurance):
Covers: This can cover outpatient care, your doctor visits, preventive services, some home health care, durable medical equipment (like wheelchairs), and other services.
Cost: Part B usually requires a monthly premium, which can vary depending on your income. There are also deductibles and coinsurance.
Important Note: While Part B is essential for covering outpatient care, some people may opt out if they have other coverage (such as through an employer).
Medicare Part C (Medicare Advantage):
Covers: A private insurance plan that includes all the benefits of Part A and Part B. Often, Part C also includes prescription drug coverage (Part D) and additional benefits like vision, dental, or hearing services.
Cost: Costs for Medicare Advantage vary depending on the plan and provider. You’ll typically need to continue paying your Part B premium, and possibly an additional premium for the Part C plan.
Important Note: Medicare Advantage plans are managed by private insurers approved by Medicare. They offer an alternative way to get your Medicare benefits.
Medicare Part D (Prescription Drug Coverage)
Covers: Helps pay for prescription drugs, including many recommended vaccines and some over-the-counter medications.
Cost: Part D has a monthly premium, a deductible, and costs for prescriptions that depend on the drug plan and the medications you need.
Important Note: Medicare beneficiaries can purchase a standalone Part D plan if they have Original Medicare (Parts A and B) or enroll in a Medicare Advantage plan that includes prescription drug coverage.
Eligibility for Medicare
To be eligible for Medicare, individuals must meet one of the following criteria:
Age: Individuals who are 65 or older and are U.S. citizens or legal residents for at least five years.
Disability: Individuals under 65 who have received Social Security Disability Insurance (SSDI) for at least 24 months.
Health Conditions: Individuals with specific conditions such as End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS).
Have questions about Medicare? Reach out to Your Friends In The Insurance Business at Ieuter Insurance Group.
Your Friends In The Insurance Business at Midland's Ieuter Insurance Group can answer your insurance coverage questions.
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