What is medicare medical insurance?

Okay folks, here’s the deal – you’re getting older. Sorry to break it to you like that, but it’s a fact of life. And unfortunately, as we age, our bodies tend to need a bit more attention from the medical profession. This attention can come with some hefty price tags – and that’s where Medicare comes into play.

Breakin’ It Down

First things first – what exactly is Medicare? In its simplest form, Medicare is government-funded health insurance for folks over 65 years old (or those with certain disabilities or illnesses). That means if you qualify for Medicare, some of your medical expenses will be covered by Uncle Sam himself.

Let’s Get Specific

Now let’s dive into some of the nitty-gritty details about this whole “Medicare thing.”

Part A: Hospitalization

Part A covers hospital stays (think surgeries or overnight visits) and related costs such as hospice care or skilled nursing facilities; however there are still deductibles and copays involved so don’t get too excited now.

Part B: Outpatient Care

Part B covers doctor visits, lab tests and outpatient procedures…basically anything not required under part A. This also includes preventative care services which really come in handy during Covid-19 times (we know y’all have been googling symptoms).

Part C: Advantage Plans

This one gets tricky y’all – Part C technically isn’t a separate entitlement like Parts A & B because it’s made up of optional private insurance plans known as “Medicare Advantage” available through third-party providers (say whaaaaaat?!).

Part D ‘The Man’

Want my honest opinion? Stay away from Mr.D aka The Man aka Prescription Drug Coverage plan….it has all sorts hoops to jump through including monthly premiums as well coinsurance every time you pick up a new prescription (hellooo saved anxiety and passed out on the floor).

In Case You’re Confused

In case our explanations weren’t crystal clear, the folks over at Medicare.gov have put it all into some handy-dandy tables that are easy to read. Y’all don’t excuse us if we go ahead and give Aunt Mildred this link – she needs all the help she can get!

Table 1: What’s Covered by Part A & B

Service Part A Coverage Part B Coverage
Doctors’ services X X
Lab tests & X-rays X X
Hospital stays “X”” ” N/A
Mind you “X” means there may still be deductibles …so its not exactly covered!

Ahhh visual helpfulness.

Alright friends, let’s dive in to who actually qualifies for this whole shindig. The eligibility requirements are as follows:

  • You must be at least 65 years old OR
  • Have a disability or illness that makes you eligible OR
  • Have End-Stage Renal Disease

That last one is intense y’all – your kidneys basically gotta fail before Uncle Sam steps in. So take care of those organs as best you can!

Can Ya ‘Afford It?’

Here’s where things start getting real interesting…let’s talk dolla bills y’all! Some folks think Medicare is completely free once they reach age 65 but sorry kids it just ain’t true!

Let Me Break It Down For You

When enrolling for Original/Regular Medicare here arwka roughly what you might expect to pay(wah-wah).

Part A
Premium Free (some people paid taxes during their working years so baseline premium rates were already deducted)

Deductible $1,484 per benefit period (all hospital services that qualify for Part A)

Coinsurance or copayment: Can accrue daily after day 61 in the hospital. Day 91 and beyond, coinsurance might increase to $742 per “lifetime reserve day” used after day 90.

Part B
Monthly Premium $148.40 or higher based on income

Deductible $203, applies to some donut care medical equipment at a tune of about 20% co-pay costs every time you visit the doc on outpatient basis

Coinsurance/Copay Generally paying about “Twenty Percent” fee yourself with Medicare also picking up eighty percent of approved plan costs.

Wait—What About Advantage?

As we mentioned earlier, there is an optional third-party insurance providers under part C . These plans are called “Medicare Advantage,” which operate similar to Exchange insurance types available from Covered California however dependant on payouts Medicare deems fit in return for certain coverage perks not provided by traditional original medicare coverage options.

Here’s your quick guide: Expect prescription drug and dental/vision insurances to be covered but can come at the cost reduced provider selection both state-wide and country wide as well as limitations by out-of-state residency limits.

On top of all these specifics there are still a lot more details so make sure y’all do your research when shopping around – this stuff ain’t no joke!

Now that you know what Medicare is all about (and hopefully won’t have nightmares caused by confusing terminology) it’s time to start considering if it’s right for you! Remember Uncle Sam isn’t covering everything free so make sure y’all get yourselves signed up correctly or end feeling kinda left high-and-dry later down road.

Oh yeah… getting old rocks!

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