Medicare

Medicare is a federal health insurance program for people age 65 and over, as well as for some people under age 65 with certain disabilities. Since 1965, it has helped millions of Americans pay for health care services they need.

When you enroll for Medicare Part A, you automatically are signed up for Medicare Part B (medical insurance) for which you have to pay a monthly premium. If you choose, you can refuse to pay for the Medicare Part B coverage. You are also entitled to receive Medicare Part A benefits if you are under 65 and have been eligible for Social Security Disability benefits for at least 24 months. This is critically important coverage for individuals who have suffered a catastrophic injury. If you are already receiving Social Security Disability benefits, you will
automatically be enrolled in Medicare Part A and Part B beginning in the 25th month. You will not be charged a monthly premium for Part A if you are on Social Security Disability. If you refuse Medicare Part B medical insurance, then a Part B premium will be deducted from your
monthly disability check. Medicare coverage will continue until you are no longer disabled. The only long term care services Medicare will pay for is a Medicare certified skilled nursing facility, part time, or intermittent home health care services or hospice care. You cannot rely on Medicare to meet either nursing home or home health expenses on a long-term basis for the catastrophically injured or disabled.

A further discussion of the Medicare coverage plans can be found below.

Hospital Coverage: Part A

Part A helps pay for inpatient hospital stays or skilled nursing facility stays after a covered hospital stay. It also helps pay for some home health care and hospice care. Medicare works the same way throughout the U.S. with any provider that accepts Medicare patients.

Medical Coverage: Part B

Part B helps pay for services like doctor’s visits, lab tests, and some diagnostic screenings not covered by Part A hospital insurance. Various medical equipment and supplies are also covered. Dental, vision, hearing, and prescription drug benefits are not included.

Medical Coverage: Part C

Medicare Advantage Part C plans are Medicare approved, but offered by private insurers. They combine hospital costs, doctor’s visits, outpatient care, and often Part D prescription drug coverage, into one plan. Some plans may offer vision, dental, hearing and/or health programs, at an extra cost. These plans often require you to pay co-pays. The doctors and hospitals you go to are usually part of a network. You may also need a referral to see a specialist.

Prescription Coverage: Part D

If you have Medicare Parts A and B, this plan can be purchased separately to help cover prescription drug costs. These plans are offered by Medicare approved private insurers—costs and covered drugs vary from plan to plan. Part D works with Medicare to supplement an existing insurance plan, or on its own. You can also get Part D benefits through some Part C plans.