Medicare

Medicare is a US national, government-funded health insurance program primarily for individuals who are 65 years of age and over, as well as for younger individuals with specific disabilities and people with End-Stage Renal Disease (ESRD). The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.

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Components of Medicare

Medicare is divided into several parts, each covering different aspects of healthcare services:

• Medicare Part A (Hospital Insurance): Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
• Medicare Part B (Medical Insurance): Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
• Medicare Part C (Medicare Advantage Plans): A type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits.
• Medicare Part D (Prescription Drug Coverage): Adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans.

Medicare Benefits Schedule (MBS)

The Medicare Benefits Schedule (MBS) is a listing of the Medicare services subsidized by the US government. The schedule includes a wide range of healthcare services, including consultations, surgical procedures, diagnostic tests, and preventive health services. The MBS is part of the wider Medicare program and is designed to ensure that all US citizens and permanent residents have access to affordable healthcare.

Eligibility for Medicare

Generally, US citizens and permanent residents aged 65 years or older are eligible for Medicare. Younger individuals with disabilities, ALS (Amyotrophic Lateral Sclerosis), or End-Stage Renal Disease (ESRD) may also qualify for coverage.

Coverage and Costs

Medicare provides comprehensive coverage for many healthcare services, but it does not cover all expenses. Beneficiaries may be responsible for deductibles, copayments, and coinsurance. Many individuals choose to purchase Medigap, a private insurance policy that helps cover some of the costs that Medicare does not.

Glossary of Terms

• Medicare Part A - The part of Medicare that covers hospital stays and other inpatient services.
• Medicare Part B - The part of Medicare that covers outpatient medical services.
• Medicare Part C (Medicare Advantage) - Medicare-approved private health insurance plans for individuals enrolled in Medicare.
• Medicare Part D - The part of Medicare that provides coverage for prescription medications.
• Medicare Benefits Schedule (MBS) - A listing of medical services subsidized by the Medicare program.
• Medigap - Private insurance policies that can help cover some of the healthcare costs not covered by Medicare.
• Deductible - The amount you must pay for healthcare services before your health insurance begins to pay.
• Copayment - A fixed amount you pay for a covered healthcare service after you've paid your deductible.
• Coinsurance - Your share of the costs of a covered healthcare service, calculated as a percent of the allowed amount for the service.

Medicare Resources
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