What is Medicare?
What is Medicare?
Medicare is one of the most popular health insurance programs among seniors, and it has a long history of helping seniors access affordable healthcare. This will cover how Medicare is paid for, what it pays for, how it works, and what you can do to get it.
Interested in learning more?
History
Medicare started in 1965 during the Lyndon B. Johnson administration. The original version wasn’t the same as it is today. At the time it only included Medicare Parts A and B (hence why the combination of the two is known as “Original Medicare” today). It was a major step forward in government-assisted healthcare and has only improved and expanded its coverage over time.
How it’s paid for
Medicare is a federal program, so it’s available in every U.S. state and every Medicare plan you join is required to offer the same benefits.
This is taxpayer-funded. You may have noticed that a portion of your paycheck goes toward Medicare. This funding allows for all seniors to have access to affordable healthcare at a time when they need it the most.
What it pays for
With this program, your coverage takes care of you in the hospital, at the doctor’s office, and the pharmacy. Medicare is split into Parts – A, B, C, and D. Part A helps you pay for hospital stays and the care you receive in hospice, psychiatric hospitals, and skilled nursing facilities. Your savings also extend to durable medical equipment such as insulin pumps and CPAP machines.
How it works
So now that we know the Parts, the next question is – how does it apply in a real-life setting? If you have Original Medicare, you’re covered in any U.S. healthcare facility that accepts Medicare.
Make sure the healthcare provider you’re wanting to see accepts Medicare. Not every doctor will accept it, and even if the doctor is in the Medicare network, he or she may not accept Medicare assignment.
If your doctor accepts Medicare assignment, then Medicare will pay 80% and you will pay 20% of the amount Medicare approves. If your doctor is non-participating, then you can still get Medicare coverage, but – you’ll be left with the 20% out-of-pocket plus. Opt-out physicians do not allow for any Medicare coverage, and if you were to seek care from these doctors, you would have to pay everything out-of-pocket.
If you have Medicare Part D, your policy will help you find the most inexpensive version of the medication you’re already taking. If your medication isn’t on the formulary, your insurer will try to find a medication most similar to the one you were previously prescribed that is on the formulary. This way, you can get your medications at the lowest price.
How it can work with you
Medicare With Jake can open the door to lower healthcare treatment expenses, with plans offering affordable premiums and minimal out-of-pocket costs all the way from our office in Wichita, Kansas. We live and breathe Medicare because we realize how crucial it is to get health insurance in the age of rising medical costs.
