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Medicare Health Insurance Explanation

Medicare is the term for a health insurance program for the following individuals:

  • People above the age of 65
  • Disabled people under the age of 65
  • People with end-stage renal disease

It consists of two parts named A and B. Part A represents the health insurance that is used in hospitals, whereas Part B represents a medical insurance.

Medicare Eligibility

The following requirements should be met in order to qualify for a Medicare:

  • Your or your spouse's employment should be covered by a Medicare
  • Be at the age of 65 or more
  • Disabled people
  • End-stage renal diseased people
  • Have a US citizenship or permanent residence status

How to Apply?

You should go to the local Social Security office in order to file your documents for Medicare. This should be done at least three months before you reach the age of 65. You are automatically offered both parts of Medicare if you have applied for Social Security benefits, but you have the possibility of not agreeing on Part B since it is offered in return to an additional payment.

Even if you don't want to take advantage of the social security program, you should strictly follow the determined time periods during which you can enroll for Medicare.

Next we continue with the various parts of Medicare and a short explanation of each.

  1. Part A - Hospitalization Coverage

    You don't have to pay premiums under the following conditions:

    • Above the age of 65
    • You are eligible for retirement benefits from the Social Security
    • You are eligible for retirement benefits from the Railroad Retirement Board
    • You are under Medicare-covered government employment

    If you are under the age of 65, you are not liable to premiums in case:

    • You receive disability benefits from the Social Security for 24 months
    • You receive disability benefits from the Railroad Retirement Board for 24 months
    • You suffer end-stage renal disease and answer particular conditions
  2. Part B - Medical Expenses Coverage

    Once you have decided to participate in Part B of Medicare, you are liable to penalties if you don't complete your responsibilities. Since January 1, 2007 the premium you are required to pay for your participation in Part B is calculated according to your income.

  3. Part C - Medicare Advantage Plan

    Similar to HMOs and PPOs, Part C of the Medicare puts together the services offered in both Parts A and B, and is mainly provided by private insurance companies, which will calculate the premium you have to pay.

  4. Part D - Prescription drug coverage

    In addition to the Part B premiums you will be charged premiums in order to participate in this part of the Medicare. What's more, if you choose to participate in the Part C of the Medicare, you may be automatically listed for Part D too. In order to find out whether this possibility is provided, you should ask your provider.

  5. Medigap Insurance - supplemental insurance

    This supplemental insurance represents a private coverage of the gaps that occur in the coverage of both Part A and Part B. It is provided by private insurance companies and the cost that you will incur varies from insurance company to insurance company.

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