Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). Medicare provides partial coverage for certain medical services. The main coverage has two parts, Part A and Part B.
Medicare Part B Medical InsuranceThe insurance provided by Medicare Part B covers medically necessary doctor’s appointments. This includes outpatient medical and surgical services, diagnostic tests and some medical equipment. It also offers coverage for home health care. Beginning in 2011, some preventive services will be covered including the one-time “Welcome to Medicare” exam.
For Part B, you pay:
- A monthly Part B premium of $148.50*.
- An annual Part B deductible of $203.00*.
- After the annual deductible, you pay 20% (Medicare pays 80%) of Medicare-approved charges for eligible services considered medically necessary.
Part B Eligible Services
- Doctor services, including hospital, clinic, office or home visits, surgery, osteopathy and radiology
- Diagnostic X-rays, labs, radiation therapy, and certain other treatments not covered under Part A.
- Medical supplies and services, including surgical dressings: splints, casts, oxygen, ventilator-assist devices and durable medical equipment used in your home.
- Ambulatory surgical center services by a Medicare-certified ambulatory surgical center
- Comprehensive outpatient rehabilitation facility services
- Unlimited visits for home health care paid at 100% when ordered by a doctor and provided by Medicare-certified home health agency.
What Original Medicare Doesn’t CoverOriginal Medicare doesn’t cover all medical costs. There are deductibles and coinsurance you must pay when you receive medical services. Original Medicare also does not cover routine preventive services, eye care and prescription medications. Your out-of-pocket expenses (the amount you pay) for these “coverage gaps” can add up quickly. Fortunately, you can enroll in several private insurance plan options to help cover the costs that Original Medicare does not cover. Some of these plan option include:
- Medicare Advantage Plans (Medicare Part C)
- Medicare Prescription Drug Plans (Medicare Part D)
- Medicare Supplement Plans (Medigap)