What is Medicare?

More Information About Medicare

Medicare is a federally funded health insurance program designed to help people age 65 and older as well as some younger people who suffer from specific disabilities and anyone who has been diagnosed with end-stage renal failure. This health insurance program is mandatory when you have reached your retirement age, even if you have different insurance at the time you retire.

What is Medicare?

Medicare is split into different sections. The two most common sections that everyone receives is Part A and Part B. each of these parts cover specific services. Parts A and B should not be confused with Part C Medicare. Part C is considered a Medicare Advantage plan and is managed separately by individual insurance companies.

What Is Covered In Medicare Part A

The first section of this insurance program covers hospitalization costs, skilled nursing centers and hospice care. Some home health care services are also covered under this portion of the insurance. However, for home health services to be approved, the doctor must certify that you are a homebound individual, that the therapies are necessary for treatment, and that without these treatments your condition would become worse. All home health services must be provided by an approved provider or they will not be covered.

What Is Covered In Medicare Part B

The second section of your health insurance plans covers your routine office visits and any type of physical exam that would help diagnose, treat or prevent an illness. This section also covers routine testing, some immunizations, durable medical equipment, ambulance use, and some outpatient medications. This is your routine coverage for everyday medical needs.

What Is Not Covered

It is very important to also understand what is not covered by your insurance plan. In most cases, this type of insurance does not cover the following services unless additional parts to the plan are purchased or supplemental insurance is used:

  • Long term nursing home care or residence in a nursing home facility
  • Some diagnostic tests
  • Medications of any type
  • Home cleaning services or assistance with these duties
  • Meal delivery services or food preparation
  • Incontinence products
  • Bandages or wound care products purchased over the counter
  • Medical emergencies that happen overseas
  • Most dental care
  • Hearing aids
  • Eye exams and glasses
  • Routine foot care
  • Dentures or partials
  • Plastic surgery
  • Acupuncture

The list of covered and not covered services is subject to change each year based on what is approved for the program. It is important to review coverage before making appointments.

Out Of Pocket Costs

This insurance does not always pay 100 percent for all of the services offered. Some medical services may cost the patient up to 50 percent out of pocket. It is important to speak with your medical care provider prior to any treatment to find out what their share of the cost will be for any services received.

Many people opt to purchase supplemental insurance policies to complement their federal plan so that they are not hit with large expenses when any medical condition needs care. These supplemental policies are available from a wide range of companies and offer different benefit packages.