All You Need to Know About Medicare

Medicare is a national program offering health insurance and funding. The program was established in 1966, under the Social Security Administration, and currently, it provided by the Centers for Medicare and Medicaid Services (CMS). Typically, this program provides health finances for all American aged 65 and above. However, the program also covers people with physical disabilities as stipulated in the Social Security Administration policies, as well as individuals suffering from end-stage renal infections.



Before this program was formed, it is believed that only approximately 60% of people aged 65 and above had health insurance. The coverage was often unavailable or non-affordable for many, as older individuals paid almost thrice more for health insurance compared to younger people.

How Does Medicare Insurance Function

Primarily, it has four major parts.

• Part A – (Hospital Insurance) It covers patients who are only formally admitted, formally admitted for three days with exceptional of custodial care, and hospice services.

• Part B – (Medical Insurance) It covers outpatient services, which include professionally administered drugs, and the provider’s office visit even if the office is within the hospital.

• Part C – it is an alternative service that allows members to choose health plans with almost the same coverage as part A and B, and often enjoys the benefit of Part D. The beneficiaries must first enroll with part A and B before signing up for this act.

• Part D – It mostly covers self-administered prescription medicines.

How to Apply for Medicaid

Medicaid is a national and federal health insurance program for people with low income. It provides free or low-cost medical benefits to eligible adults, children, pregnant women, and people with disabilities. Some individuals are dual-eligible for both Medicare and Medicaid funding. In some states, Medicaid pays Part B premium for individuals making below a guaranteed earning income, as well as some out of the pocket hospital and medical expenses.

Generally, for any individual above 65 years who have received social security funding, he or she is automatically enrolled in Part A and Part B. However, if the individual is still employed and receiving employer insurance, he or she might opt to sign out in Part B program. Delay in enrollment for Part B carries no penalty if the individual is still receiving insurance funding from other health institutions. Penalties may arise if an individual fails to enroll at the age of 65 and doesn’t have any additional insurance. Members are to carry with them Medicare cards to facilitate efficient service delivery.

How Medicare Differs with Private Insurance