Are you turning 65 this year or caring for someone who is (or will be)? If so, there is no time better than now to start doing some research on Medicare. You’ve seen the commercials before – Medicare Open Enrollment, Part A, Part D…. but what does it all mean? For starters, take a look at your most recent paycheck. Do you see the letters FICA on it? That stands for the Federal Insurance Contributions Act, which is composed of Social Security and Medicare taxes. So now that you know if you have been paying for your Medicare, here are our answers to some of the frequently asked questions surrounding it.
What is Medicare?
Medicare is the federal health insurance program for people who are 65 years of age or older. In addition, those under 65 with certain disabilities (or specifically, End-Stage Renal Disease) may qualify for Medicare. The single-payer system uses roughly 30-50 private insurance companies to administer the Medicare coverage to those aged 65+.
Who is in Charge of Managing Medicare?
The Centers for Medicare & Medicaid Services (CMS), within the U.S. Department of Health & Human Services (HHS) oversees the Medicare program.
Who is Eligible for Medicare?
Similar to Social Security, Medicare is an entitlement program. Most U.S. citizens earn the right to enroll in Medicare by working and paying their taxes for a minimum required period (typically at least five years). Even if you didn’t work long enough to be entitled to Medicare benefits, you may still be eligible to enroll, potentially at a higher price.
How Does Medicare Work?
There are four different parts to the Medicare program. Parts A and B (referred to as Original Medicare), Medicare Part C, and Medicare Part D. Here is a further breakdown:
- Part A (hospital insurance) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay). Part A also pays for some home health care, and hospice care (which may help caregivers).
- Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
- Part C (Medicare Advantage plans) is available in many areas. People with Medicare Parts A and B can choose to receive all their health care services through a private insurance company approved by Medicare.
- Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs.
It is quite common to get turned around when navigating Medicare—figuring out what you qualify for and trying to determine which coverage you need. The best advice is to ask plenty of questions to your physician and insurance providers, and to make use of other resources such as the AARP Medicare Resource Center or the Medicare Caregiver Resource Kit.