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What Is Medicare Insurance

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Medicare insurance is among those programs. It is a health insurance for people who are 65 years old and above, with certain disabilities under 65 or for people who suffers permanent kidney failure, which requires dialysis or a kidney transplant.



We may be able to avail of this program in any of the following options:

The Original Medicare Plan

This is the so-called ?fee-for-service? health plan. You must pay the deductible. The Medicare pays its share of the approved amount and you pay your share.

Under this plan, you will be charged a fee for each health care service or supply you availed. It is managed by the Federal Government and is available nationwide. Those who are in the Original Medicare plan use the red, white and blue cards.

It has two parts:

(1) Hospital insurance and

(2) Medical insurance

The Medicare Advantage Plans

These are health plan options that are approved by Medicare and run by private companies like Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). Most of the option offers prescription drug coverage.

HMO is a type of plan available in some areas of the country. Plans must cover all Hospital and Medical insurance areas. In most HMOs, you can only go to doctors, specialists, or hospitals on the plan's list except in an emergency. Your costs may be lower than in the Original Medicare Plan.

PPO on the other hand is available in a local or regional area in which you pay less if you use doctors, hospitals and providers that belong to the network. Additional costs are incurred for use outside of network.

You generally get all your Medicare-covered health care through one of those plans, which also include:

?Private Fee-for-Service (PFFS)

?Special Needs Plan

?Medicare Medical Savings Account

Other Medicare Health Plans

These plans are no longer part of the Medicare Advantage but are still part of the Medicare Program. Under these plans, Medicare either:

?pays a set amount of money every month

?reimburses the plan's reasonable cost for your care

They provide hospital insurance, medical insurance coverage and some provide Medicare prescription drug as well. Others included are:

?Medicare Cost Plans

?Demonstration/Pilot Programs

?Programs of All-inclusive Care for the Elderly (PACE)

The US Department of Health & Human Services released certain rights and protections for those who have Medicare, they are:

1.Be treated with dignity and respect at all times

2.Be protected from discrimination

3.Get information about Medicare that they can understand to help them make health care decisions

4.Have their questions about Medicare Programs answered

5.Culturally competent services

6.Get emergency care when they need it

7.Learn about all of their treatment choices in clear language that they can understand

8.File a complaint. (They may opt to do this with a Medical insurance attorney)

9.Know their Medicare appeal rights

10.Have their health information that Medicare collects about them kept private

11.Know the health information privacy rights
What Is Medicare Insurance
If You Already Receive Social Security Benefits

If you're over the age of 65 and receiving regular Social Security benefits, you should already be enrolled in Medicare and don't have to do anything else. By registering for your Social Security, you also registered for Parts A and B of Medicare at the same time. There is no need to fill out an additional Medicare application.

Medicare should begin the month you turn 65. For example, if your 65th birthday is on October 15, 2009, your Medicare eligibility will begin on October 01, 2009. Once you apply for your Social Security, your Medicare card will be mailed to you several months before your 65th birthday. If you wish to opt out of Medicare Part B, simply return the card.

Applying for Social Security and Medicare at the Same Time

If you're coming up on 65 but have yet to apply for Social Security and Medicare, you should do so at least three to four months before your 65th birthday. Applying for Social Security will automatically register you for Medicare. Failure to apply on time could result in your benefits being delayed.

Eligibility for Medicare

Generally, most people are eligible for Medicare - as long as you or your spouse worked for a minimum of 10 years with a Medicare-covered employer (most employment scenarios are eligible), are over the age of 65 and currently a resident in the United States. Those with certain types of long-term illness or a disability may also qualify for Medicare.

The Social Security and Medicare Application Process

To apply for Medicare and Social Security, visit a local Social Security Office or call the Social Security Administration at 1-800-772-1213. You can also fill out an application online at their website, which can be found at socialsecurity.gov.

To be eligible for an online application, you must prove your identity by answering a series of questions. You will also be required to prove your eligibility - you should be at least 61 years and 9 months old, you must be planning to start your Social Security benefits within the next 4 months, you must live in the United States and you must be willing to receive your Social Security benefits through direct deposit.

Applying for Medicare, but not Social Security

Many people assume that if they do not already receive Social Security benefits, they do now qualify for Medicare. This is not the case.

If you do not receive Social Security or do not plan to receive the benefits, you can still obtain Medicare. To do so, you must fill out a separate Medicare application. You can do so by calling the Social Security Administration at 1-800-772-1213 or visiting a local Social Security office.
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