MEDICARE: A federal “Fee-for-Service” health insurance assistance program for individual or families with limited income.

WHAT IS MEDICARE?

Medicare is a health insurance program funded and operated by the federal government. Medicare is a “Fee-for-Service” plan for disabled parsons (of any age) and persons 65 years of age or older. With some service benefits being minimal or limited, depending on the plan or circumstances. Medicare has two main plan types and multiple supplementary plans.

WHAT DOES MEDICARE PAY FOR?

Medicare is federally-funded and eligibility requirements are determined by which state you live in and their resources or guidelines. Here’s a list of coverage types that MAY be covered:

• Physician and dental services
• Prescription drug coverage including medicine, medical equipment and supplies
• Ambulance transportation (Emergency)
• Optometrist services and eyeglasses
• Transportation to doctor appointments, including public transportation, car mileage and special services.
• Smoking cessation agents
• Treatment and preventive health and dental care (doctors and dentists)
• Family planning services
• Early periodic screening, diagnosis, and treatment for children under 21 years of age under the Child/Teen Health Program
• Some insurance and Medicare premiums
• Rehabilitation and physical therapy services.
• Home and community-based care to certain persons with chronic impairments.
• Clinic and inpatient / outpatient hospital services
• Laboratory and x-ray services
• Care in a nursing home
• Home health care services
• Family planning services
• Prenatal care services
• Mental health care and psychiatric hospital care
• Pediatric care services

Typically the above items are paid for by Medicaid. However, certain expenses and coverage’s may not be covered due to certain criteria, such as:

• If you’re receiving SSI
• Living arrangements
• You age
• Level of disability (if applicable)
• The plan you choose

MEDICARE PLAN TYPES

Medicare offers you different ways to get your Medicare benefits. These different options are called Medicare health plans.

The two main types are Medicare Part A and Medicare Part B.

• PLAN A
  • Coverage
  • Hospital stays
  • Skilled nursing facility
  • Hospice care
• PLAN B
  • Coverage
  • Doctor services
  • Outpatient hospital services
  • Medical services that Part A doesn’t cover

Other types of Medicare

• PLAN C or Medicare+Choice
  Coverage
• Same options as described above, plus:
• Extended hospital benefits
• Additional Medication coverage
• Lower co-payment (with HMO plan)

MEDIGAP
Coverage can include:

• Additional benefits to pay Medicare deductibles, co-payment, etc.
• Improved Medication coverage
• Improved eye coverage (including glasses)
• Improved dental coverage

MEDICAID
Coverage can include:

• Additional benefits to pay out-of-pocket expenses
• Improved eye coverage (including glasses)
• Improved dental coverage
• Improved medication coverage
• Nursing home coverage that outlasts Medicare.

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HOW DO YOU APPLY?

Contact your local Department of Human Services, Social Security or Welfare office. When yo go in for an interview, check and make sure what you will need to bring in with you, some circumstances may need additional paperwork. However, you will need (ATLEAST) the following:

• Birth certificate
• Citizenship proof
• Proof of income
• Paycheck stubs
• Insurance policy
• Bank Records
• Medicaid card (if applicable)
• Insurance card

IN CONCLUSION
Medicare pays limited amounts of coverage. For years now, Medicare stop reimbursing hospitals in full for services and created a set fee structure. Medicare also set a number of days allowed for patient inpatient hospital stays. After allotted time of stay Medicare stops payment regardless of patient’s need or financial resources (or the lack there of).

FINDING A FINANCIAL ADVISOR
A financial advisor can ensure you’re saving enough to meet all your immediate and retirement needs. Find out what’s best for you and your retirement goals! Learn more about the different asset allocation types, explore the areas above and fill out our on-line form to find a certified financial advisor in your area.