Aging and Your Health Coverage: Your Guide to Medicare
The United States Census Bureau reports that nearly one in five Americans are on Medicare. A federal program, Medicare is the backbone of health coverage for senior citizens. Most people have a general understanding of Medicare, but there are many myths and misconceptions about how the program actually works. In this article, our St. Petersburg elder law attorney provides a guide to the most important things that you need to know about Medicare.
What is Medicare?
Medicare is a federal health insurance program primarily for senior citizens (people aged 65 and older). With that being said, certain younger people with disabilities may also qualify. Medicare is not a needs-based program. All U.S. citizens are eligible to enroll in Medicare once they reach 65. Though, you do need to enroll in the program. It will not happen automatically, nor is it required.
Medicare is a Four-Part Federal Health Insurance Program
One of the most common misconceptions about Medicare is that it is “one” thing. That is not the case. Medicare actually has four different parts. They each work differently and not every Medicare beneficiary will have all types of benefits. Here is an overview of the different aspects of Medicare:
- Medicare Part A: Medicare Part A covers inpatient hospital care, skilled nursing facility stays, hospice care, and some home health services. It is often referred to as “hospital insurance.” Most people do not pay a premium for Part A. With that being said, there are deductibles and copays for some people.
- Medicare Part B: Medicare Part B helps pay for outpatient care, doctor visits, preventive services, and durable medical equipment. It is known as “medical insurance.” Most people pay a monthly premium for Part B. The cost of the monthly premium is based on their income and it is designed to be reasonably affordable. There is an annual deductible.
- Medicare Part C: Medicare Part C (Medicare Advantage) is offered by private insurance companies approved by Medicare. These plans combine Part A and Part B coverage and often include additional benefits like vision, dental, and prescription drugs. Enrollees still pay their Part B premium. Beyond that, they usually must pay an additional plan premium.
- Medicare Part D: Finally, Medicare Part D provides prescription drug coverage to help lower the cost of medications. It is offered by private insurers approved by Medicare. Part D plans have monthly premiums, annual deductibles, and cost-sharing for prescriptions.
Medicaid, Not Medicare is the Primary Program for Long-Term Care Needs
Seniors and their families should know that Medicaid, not Medicare, is the primary source of coverage for long-term care, including nursing home stays and in-home assistance with daily activities. Medicare provides limited coverage for skilled nursing care, typically only after a hospital stay and for a short duration. Medicaid is a strictly mean-tested federal program. You should have a Medicaid plan in place as part of your estate plan. It is important for long-term care planning.
Consult With Our St. Petersburg Elder Law Attorney Today
At Fisher & Wilsey, P.A., our St. Petersburg elder law attorney has the knowledge and experience that you can rely on. If you have any questions or concerns about Medicare, we can help. Give us a call now or please do not hesitate to contact us online to set up your confidential consultation. With an office in St. Petersburg, we provide elder law services throughout the wider region.
Source:
census.gov/library/publications/2024/demo/p60-284.html
