What is medicare health insurance?

Helping North and South carolina understand the details about medicare

Medicare Simplified

By definition, Medicare is a national program designed to assist people 65 and older, people with certain disabilities, and people with end-stage renal failure get the healthcare they need via federally subsidized health insurance. Though originally limited to Part A and Part B at its inception in 1965, the coverage Medicare provides has since evolved to include more people. Federally-regulated supplemental policies have also been made available to help fill in any coverage gaps.

 

The ins and outs of Medicare can be difficult to track if you haven’t studied it for years like we have, so count on us to help you navigate your policy selection. Carolina Insurance Partners has access to a network of insurance providers, allowing us to shop multiple vendors and compare pricing to make sure you’re getting the lowest price for the same coverage. Reach out to us today to get started.

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What Does Medicare Cover?

Medicare Parts A and B, combined with the many supplemental policies available, can be combined to cover virtually all healthcare expenses for those who qualify. Coverage and premiums differ by policy, so be sure to work with an insurance agent who can show you the differences, narrow down the options likely to work best for your situation, and help you choose the Medicare coverage that’s right for you.

Medicare Part A

Medicare Part A covers your inpatient care—your stays at hospitals and skilled nursing facilities. It covers the cost of a semi-permanent room and food. It doesn’t cover many of the actual treatments you might receive, but most of those are covered under Part B.

For most people, the cost of Part A is $0—provided you paid into Social Security during your working years. If you don’t automatically qualify for free coverage, you can still apply.

Medicare Part B

You can think of Part B as your outpatient care. It provides coverage for things like doctor’s visits, lab work, preventive services, surgeries, and more. It also covers more expensive treatments, like chemotherapy and radiation for cancer and dialysis for kidney failure.

Premiums for Part B are determined by your adjusted gross income and are set by Social Security year to year. People in higher income brackets will have higher premiums than those in lower income brackets. You must have Part B to take advantage of supplemental policies, so don’t skip it!

Medicare Part D

Medicare Part D, often referred to as a “Drug Card,” offers prescription drug coverage.  Part D is an option for any individual with Medicare. 

As a part of your monthly premium for your Part D plan, you use the insurance carrier’s network of pharmacies to purchase prescription drug medications.   

In order to avoid a Part D late enrollment penalty, you need proof of credible drug coverage.  

 

 

Medicare vs Medicaid

Though the names are similar, Medicare and Medicaid are government programs set up to help different groups of people. Medicare was created to provide health insurance to people 65 and older, while Medicaid was introduced to provide financial assistance to low-income individuals to ensure they have access to needed healthcare.

In some cases, people qualify for both. When this occurs, Medicare acts as your primary insurance, and Medicaid is secondary.