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A Starting Guide for Medicare



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Medicare Defined

Medicare is a federal medical insurance, established by Congress in 1965, for individuals who are ages 65 and older, disabled, or suffering from unique ailments such as End Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD), Black Lung, and other applicable illnesses. Medicare currently serves more than 44 million enrollees and is funded through the Hospital Insurance Trust Fund and the Supplementary Medical Insurance Trust Fund.

Different parts of Medicare help cover specific services. Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Medicare Part B is for medical insurance needs such as doctors' services, outpatient care, medical supplies, and preventive services. Medicare Part C relates to Medicare Advantage Plans, which are offered by private companies that contract with Medicare to provide Part A and Part B benefits. Most Medicare Advantage Plans also include prescription drug coverage. Finally, Medicare Part D adds prescription drug coverage to specific Medicare plans.

Medicare Eligibility

Anyone who meets the general eligibility requirements mentioned above should contemplate and evaluate their need of Medicare as a medical insurance option. In addition, eligibility for Medicare requires that an individual is a U.S. citizen or permanent legal resident for five continuous years and is eligible for Social Security benefits with at least ten years of payments contributed into the system. Typically, Medicare should be applied for within four months prior to turning age 65, during the disability application process, or after an individual no longer has a group health plan through current employment.

Medicare Benefits 

Since it began, Medicare has provided universal health care to millions of seniors. Not only is Medicare efficient, it provides a greater health equity in America. Among the biggest reasons why Medicare is universally appreciated is it offers guaranteed health benefits in return for the contributions individuals make during their working years.

Even if an individual is still working and his or her employer offers health insurance benefits, it is advisable to inquire about options with Medicare. Our partner, FEDlogic, looks forward to helping you understand your options. Contact LBMC EP today to inquire about Medicare and FEDlogic’s services!

A Starting Guide for Medicare