Medicare is a health insurance program that was an initiative taken by the federal government to provide health care coverage. The program has been designed for people who are older than 65 years , some people under 65 years of age, those who are receiving Social Security Disability Insurance (SSDI) for a specific time or those who are suffering from End-Stage Renal Disease (ESRD).
A federal agency named Centers for Medicare & Medicaid Services (CMS) is responsible for running the Medicare Program. The funding of the program is done through Social Security and Medicare taxes that all individuals pay on their income and through premiums paid by the people who have been enrolled for the Medicare plan. Some part is also funded by the federal budget.
Once a person becomes eligible for the Medicare program and gets enrolled in the Medicare plan, then, depending on their health care needs, they can choose from Original Medicare or a Medicare Advantage Plan. Original Medicare is a traditional program known as fee-for-service that is offered directly by the federal government. The Medicare Advantage Plan is a private insurance plan that is mostly offered by companies that have a contract with Medicare or the federal government.
Original Medicare comprises of Part A that includes inpatient or hospital coverage and Part B that includes outpatient or medical coverage. If someone wants Medicare prescription drug coverage Part D to be included in the Original Medicare then he or she is required to choose a stand-alone Medicare Private Drug Plan (PDP).
If someone chooses to enroll in a Medicare Advantage Plan then they will still have Medicare which means that they will still have a monthly Part B premium along with their Part A premium. Every Medicare Advantage Plan provides Part A and Part B services that were covered in the Original Medicare. However, there are different rules, restrictions, and costs that lay an impact on how and when an individual receives health care. The Medicare Advantage Plans also provide coverage of Part D services.
If someone has health coverage from a current, union, or former employer then he or she will be eligible for the Medicare plans and will be automatically enrolled in the Medicare Advantage plan sponsored by them. It is the choice of the individual whether he or she wants to go with this plan or enroll in a different Medicare Advantage plan or even switch to the Original Medicare plan.
However, it is recommended that you discuss it with the employer or the union before making any decision. Choose a competent Medicare Insurance Agency that will help you in choosing the most appropriate Medicare plan by analyzing your health care needs. You must have a clear understanding of the choices under Medicare coverage and carefully select the best option among the different health care options available.