Medicare Can Be Confusing To Understand At Times, Learn More About The Different Types Of Medicare In Order To Find The Best Fit For You.
A lot of people get confused when it comes to their Medicare health plans. Experts liken the government-backed health insurance to a park with paths that lead to different areas where different activities can be done. Wherever area a person may happen to go, they would still be in the park. With Medicare, individuals can pick different types of health care programs. They can also decide on how they want to receive their medical services. But all in all, they would still be under the Medicare system.
Medicare is divided into four parts; A, B, C, and D. Parts A, B, and D offer coverage for various kinds of health care. Medicare Part A pays the cost of hospitalization and other types of confinement for health reasons such as hospice care, skilled nursing facility, or home health care. Medicare Part B covers the cost of going to your doctor and of using other patient services that have been approved by Medicare. Part D, being the prescription drug insurance, covers the cost of your medication. Medicare Part C is not a type of coverage. It provides options to beneficiaries in terms of the way they would want to receive their health benefit.
The ways by which you may receive your Medicare benefits is either through Traditional Medicare (also called the “Original Medicare”), or through Medicare Advantage. Traditional Medicare is the way this health insurance has been offered since its inception in 1966. Traditional Medicare will make you pay a portion of the expenses for hospitalization (Part A) and medical services (Part B). The typical hospital deductible is about 20 percent of the expenses for outpatient services. The remainder is directly paid by your Medicare coverage to the health care provided.
As mentioned, another way of receiving your medical care and services under Medicare is through the Medicare Advantage Plan or Medicare Part C. This portion of Medicare allows people to pick different alternatives to Traditional Medicare. Medical care under Part C is provided by private insurance companies that have been approved by the Center for Medicaid and Medicare. Each year, Medicare provides every plan with a fixed amount of money for the medical care of the enrolled individual. This is regardless of how much care an insured individual need. All plans under Medicare Advantage are required to offer the same medical care and medical services as the Traditional Plan do at the very least. But Medicare Advantage offers more care and service than the traditional plan. Most Medicare Advantage plans charge a monthly premium while others do not require any premium.
Medicare Advantage plans may be in the form of an HMO that operates in local areas. Under this plan the patient can go to a doctor or health care facility within the network designated by the plan provider. The patient would also need to go through a primary care physician to get a referral for the medical care that they need.
The Advantage plan can also take the form of a Preferred Provider Organization which can operate in counties or in entire regions. Providers offering this type of plan have their own network of physicians and medical care services, but the patient may opt to visit doctors or receive medical services from outside of the network if they prefer higher copayment.
Advantage plans can also take the form of a “private fee-for-service” plan that allows you to go to your preferred providers as long as they accept the payment scheme under your plan. You can go to any health care facility or any physician anywhere in the U.S. These plans also have a network of care providers and services but you may still go to your own doctor or hospital for additional copayment.
Another form of Medical Advantage is the Medicare medical savings accounts where individuals can deposit a part of the money they get from Medicare into a personal health savings account. They can then use this account to pay for medical services. Once the funds are depleted, patients will then pay out-of-pocket until a deductible is fully paid. Once the deductible is paid the plan kicks in and covers all of the patients’ medical expenses for the rest of the year. The money left in your medical saving account is yours to keep or to re-enroll in another medical savings account for the new year.
Special Needs Plans may also be used for Medicare Advantage. These plans can either be an HMO or preferred provider organization. The plan is designed to serve the needs of a special category of beneficiaries, including those with a disabling or chronic illness or those requiring institutional care like those provided in a nursing home.
The last part of Medicare is the prescription drug coverage otherwise known as Medicare Part D. This plan is offered by private insurance companies. They may be stand alone plans that are separate from Medicare Part A and B or Medicare Advantage, or you can receive it through a Medicare Advantage plan that offers it.