Nowadays, to be and to feel secured about everything does not happen easily. People worry about what tomorrow will bring especially when it comes to their health. Good thing that there is a way to protect oneself before, during, and after an illness or disability strikes and that is through health insurance. Another good thing is that Americans have the Medicare insurance in 2018 to help them financially cope with sudden illnesses.
A social insurance program by the US federal government, Medicare provides health insurance coverage, generally, to people aged 65 years old and above, and other groups of younger people, under certain conditions. Funded through the Social Security Administration, Medicare covers half of the health care costs, on the average, while the remaining expenses must be paid by the beneficiary either as an out-of-pocket expense, or through a supplemental or separate insurance which they would may get from a private health insurance provider.
Who are qualified to get Medicare insurance 2018 coverage?
There are groups of people who automatically get their Medicare coverage while some will have to sign up for it. Persons who are already getting benefits from the Social Security or the Railroad Retirement Board (RRB) will have Medicare coverage starting on the first day of the month that they will turn 65. Those who are under 65 years old, with disability, and have been receiving disability benefits from the Social Security or RRB also automatically get coverage under the program after they have received 24 months’ worth of benefits. On the other hand, those who have Amyotrophic Lateral Sclerosis will automatically qualify for Medicare coverage as soon as they start receiving their disability benefits from the Social Security.
Meanwhile, those people who are turning 65 soon but do not receive disability benefits from neither the Social Security nor the RRB will need to sign up for Medicare Parts A and B. It is important that they immediately sign up for Medicare insurance the first time they become eligible for it, or they will end up paying a late enrollment penalty for as long as they are covered by Medicare Part B.
Persons afflicted with End-stage renal disease who want Medicare coverage may also sign up for Parts A and B.
How to sign up?
Those who need to sign up for Medicare insurance in 2018 will need to take note of their Initial Enrollment Period which will begin three months before the month they turn 65 and ends three months after they turn 65. Coverage under Medicare insurance Parts A and/or B will start at the first day of their birthday month. For those whose birthday falls on the 1st day of their birth month, Medicare coverage will start on the first day of the previous month.
What does Medicare insurance in 2018 offer?
The package of benefits offered by the Medicare program is divided into four namely Parts A, B, C, and D.
Part A covers for the hospital insurance which includes inpatient care in a hospital, skilled nursing facility care, hospice care, home health care, and inpatient care in a religious nonmedical health care institution.
Under inpatient care, Medicare will help cover for the cost of the room, meals, and medicine consumed by the patient while he is being treated at the hospital. A patient who needs daily skilled care may get coverage for his stay inside a skilled nursing facility provided that his doctor certified that it is medically-necessary for his treatment or recovery.
Hospice care is also covered under Part A Medicare for patients who are terminally-ill and have a life expectancy of less than six months. Home health care will be also covered by Medicare for those patients who have a hard time leaving their homes without help or if it will be difficult for them to leave their houses because of their medical condition.
Part B of Medicare, on the other hand, covers medical insurance and helps pay the cost of outpatient health care, services of a doctor or other health-care provider, home health care, durable medical equipment, and for preventive and wellness services.
If a patient receives outpatient hospital services, Medicare will help cover the cost for it. This includes a variety of diagnostic and treatment services and procedure such as X-ray, casts, stitches, outpatient surgeries and other laboratory services.
Medicare also provides coverage for the services of a doctor or other health care providers such as nurses, social workers, physical therapists, and psychologists. It also covers items which are considered as durable medical equipment such as wheelchairs, walkers, and others.
The health care insurance also helps cover services to help prevent or detect illness and disabilities.
Meanwhile, Part C, or otherwise known as the Medicare Advantage Plan, provides Medicare coverage, specifically, Parts A and B but through a Medicare-approved private company and not under the Original Medicare. Aside from offering Parts A and B, most Medicare Advantage Plans offers vision, hearing, and dental care, as well as other health and wellness programs. Some of these plans also offers Medicare Part D, or the prescription drug coverage, as part of their package of health care benefits. Do note, however, that signing up for this plan entails payment of monthly premium, on top of what will be paid for Part B premium.
Lastly, Part D of Medicare insurance provides for prescription drug coverage. Also known as Medicare Prescription Drug Plans, it also charges a monthly premium and a late enrollment penalty, should a person enrolls for it later after his initial enrollment period has ended.
A Part D plan has a formulary, or list of covered drugs, which may differ among plans. In order to avail of the prescription drug coverage under this plan, the patient and the medical practitioner prescribing the medication must be able to secure prior authorization from the plan provider before filling up a prescription. Take note that there is a quantity limit on how much medication a person may take and the Medicare insurance 2018 drug plan will also conduct safety checks on the medications prescribed before covering for the said drugs.