Medicare is an effective national healthcare plan for U.S. citizens, started in 1965 under the Social Security Act and currently administered by the Centers for Medicare & Medicaid Services. It provides health care coverage to people aged 55 years and above, as well as disability, burial, and cremation expenses. Through this plan, U.S. taxpayers can receive both medical and nursing care in many of the private health care facilities that are available through Medicare while they remain covered under their primary health care insurance. This has made Medicare one of the most successful lines of protection for U.S. seniors. While Medicare does provide significant benefits, it does have a few drawbacks as well, and these can pose a significant challenge to some senior citizens who are considering re-enrolling or changing policies.
First, there are many differences between the various Medicare plans. Each type of plan has different reimbursement options for doctors’ services, hospital stays, and medications. This can make choosing a physician or hospital extremely confusing. It may be necessary for a senior citizen to switch plans when they switch physicians or need to take a new medication. If the senior does not understand what they need from their new plan, it may be more difficult for them to accurately obtain these services.
Second, it is important to remember that Medicare does not cover any pre-existing conditions. To be eligible for Medicare coverage, you must have been receiving Medicare and have had Medicare coverage for at least five continuous months. To keep the coverage from lapsing, a person must remain covered under their primary Medicare policy, or a policy that covers similar services may be required. Pre-existing conditions are considered an illness or condition that was present before enrollment in Medicare. Even age-related conditions, such as diabetes mellitus, are considered pre-existing conditions.
Third, there are certain benefits that Medicare does not cover. Some of these are extended hospital stays, specialized surgical procedures, and inpatient care. Besides, there are usually deductibles and coinsurance that must be paid. Before deciding whether a service or provider is covered, patients should consult their physicians.
The fifth most common Medicare fact is that premiums for Medicare do not start until you are age 65. Since older adults typically have more chronic health care needs, the cost of Medicare tends to be much higher than younger people. This fact has helped to reduce the number of seniors who sign up for Medicare. As the number of seniors on Medicare grows, so does the number of fact questions.
Knowing a few important facts about Medicare can help anyone determine if they are planning on signing up for the program. Since the coverage is often confusing, it is important to discuss it with a Medicare representative before deciding. With the information contained herein, seniors will have a better understanding of their future Medicare.