What Americans get from Medicare

In this guide, we will be talking you through everything you need to know about Medicare Healthcare in 2021.

Medicare

What is Medicare?

Medicare Healthcare is a Federal program that offers an alternative option to private insurance. The cover is paid for by the Federal Government due to the Affordable Care Act.

Medicare covers Parts A, B, and D of Healthcare Provision.

Who Qualifies for Medicare?

The following groups of people qualify for Medicare Healthcare:

  • People with End-Stage Renal Disease ( ESDR is a permanent kidney failure that requires a transplant or permanent dialysis)
  • Members of the public who are over the age of 65
  • Young people with certain disabilities (see here for more information)

Medicare is designed to prove medical care for people who would otherwise not qualify for cover or would not be able to afford private Healthcare cover. 

Medicare us

What are the different parts of Medicare?

Medicare covers three parts of Healthcare provisions: Parts A, B, and D:

Part A – (Hospital Insurance)

            This area of the insurance covers hospice care, inpatient hospital care, care in nursing homes, and other forms of personal healthcare.

Part B – (Medical Insurance)

            This area of the insurance covers preventative care, outpatient care, medical supplies, and doctors’ services.

Part D – (Prescription drugs cover)

            This area of the insurance covers many vaccines, shots, and prescription drugs.*

*Part D is available on both Ordinary Medicare and Medicare Advantage. The range of drugs covered by each plan varies. Different formulas of common drugs are graded. Not all grades are available through Medicare. There is a more detailed list of drugs covered on the Medicare website.

What are the Premiums for Parts A and B?

The major thing that affects the premiums for Medicare is which plan you chose and how long you have been paying taxes for.

In general, the longer you’ve been paying taxes the better deal you will get.

Plan A costs –

Plan A will have to be paid for unless:

  • If you can claim Social Security or Railroad Retirement benefits (over 65)
  • If you can claim Social Security or Railroad Retirement benefits, but haven’t yet (over 65)
  • Your spouse or yourself had government covered Medicare (over 65)
  • You have End-Stage Renal Disease (ESRD – all ages)
  • You have had Social Security or Railroad benefits for 24 months (under 65)

If you do not fit into these categories then it is possible to buy Plan A from Medicare.

This will cost you:

If you have paid Medicare taxes for over 30 quarters (7 ½ years total) – $252 per month

If you have paid Medicare taxes for less than 30 quarters (7 ½ years total) – $458 per month

Plan B Costs –

Everyone must pay the premium for Plan B.

At $144.60 per month, it is significantly cheaper than private Healthcare Insurance.

If you have earned over a certain amount in the last 24 months then you may have to pay an Income Related Monthly Adjustment Amount (IRMAA) on top of your premium. 

How Does Medicare Work?

There are two types of Medicare cover available: Medicare Original and Medicare Advantage.

Medicare Original

This covers most of the services offered by the American Healthcare system.

Original customers are required to pay a deductible at the start of every year. You will pay around 20% of the medical bills as long as they are approved by Medicare (these will be considerably lower than private cover).

When on medicare it is possible (and recommended) to get some kind of Medigap coverage.

If you wish to add Plan D (prescription drugs and vaccine cover) to your policy you can.

Medical bills accrued outside of the United States are not covered.

Medicare Advantage

Medicare Advantage is a newer offering from Medicare.

Medicare Advantage is an all in one bundle that includes Plan A, B, D, dental, vision, and hearing cover. Many of which are not included in Medicare Original.

The out-of-pocket cost limits will be unique to each individual. It is possible to get Medigap cover whilst using Medicare Advantage.

Medicare Advantage has yearly contracts, any changes in status must be presented to Medicare before renewal. Medicare Advantage does cover international travel.

Do I need any Supplementary Cover?

As we mentioned above Medicare recommends that you take out a Medigap Supplemental cover on top of its policies.

This kind of Supplementary Cover is designed to reduce the owner’s out-of-pocket expenses to next to nothing.

Check out this Thrivent Medicare supplement review by Bluewave Insurance for a good idea of what Medigap cover can provide you with.

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