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Medicare Health Insurance In The US

By: EconomyWatch Content Team Date: 4 February 2010

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The Medicare Health Insurance program is a federally funded program that is in place to assist residents of the United States who are 65 years of age or older and/or are disabled who cannot afford private insurance. Individuals who satisfy the eligibility requirements for Social Security automatically qualify for the Medicare hospital insurance, which is considered to be Part, A once, they reach their 65th birthday.

Like so many other insurance plans, Medicare does not pay the total cost of one’s medical bills. The coverage under the Medicare system is broken down into four parts. They are identified as Part A, B, C and D. To get the Original Medicare you would be provided with Part A which is basic coverage for going to the hospital. You would also be covered for Part B which includes visits to physicians and services on an outpatient basis. The medical services that you receive can be administered to you by way of any doctor and/or hospital that are willing to accept Medicare.

There are some routine costs that are not covered by Medicare Health Insurance. For example, vision care is not covered. This includes eye examinations, eyeglasses and contact lenses. Dental care in terms of cleanings, fillings and getting dentures is also not covered by Medicare. Unless you have Medicare Part D coverage you are not covered for any outpatient prescription drugs. Finally, long-term care is not covered under this federal program. This includes custodial care which takes into consideration daily living assistance for bathing and dressing. If you require any of these things then you must pay for them out of your own pocket.

There are gaps in the Medicare system, which is unfortunate for those who require this plan for their health insurance needs. In order to fill the gaps you can purchase private insurance known as Medigap coverage. This will help you pay for the services that Medicare is not able to pay for. Medigap insurance programs are standardized and are all regulated by the government.

Let us briefly take a look at Part A and Part B of the Medicare plan. Part A is hospital insurance. This part of the plan includes inpatient care when in the hospital as well as skilled nursing facilities both when you are at home or if you are in a hospice. The member of Medicare must pay co-insurance and deductible charges on their own.

Part B covers medical insurance. This element of the coverage pays for the services of doctors as well as medical equipment and medical supplies. Medicare Health Insurance pays for 80 percent of your approved expenses. Part B also necessitates that you pay for the deductible and the co-insurance with your own money.