When people hear the word,Medicare, they often believe it is one comprehensive healthcare plan, oftenonly offered to the disabled and the underprivileged. While it does help thosein need, as well as those who are unable to procure health insurance any otherway, Medicare comes in several forms depending on the patient’s needs, as wellas what the government and healthcare assessment deems necessary on thepatient’s behalf. Essentially, Medicare can be broken down into four parts,known as Plans A, B, C, and D. While some are similar, each has their owndistinctions separating them from one another.
MedicarePart A it typically known as, “Original Medicare.” When most people think ofwhat Medicare offers, and to whom they offer it, they are often thinking of theinitial Medicare A package. Today Medicare A is represented by hospitalcoverage (Marmor, 2017). Managed byMedicare, it covered a variety of hospital-related visits and issues on behalfof the patient. For example, Medicare A offers covers and benefits for hospiceand home health services, inpatient stays in a variety of skilled nursinghomes, and inpatient hospital care for those who require it. Based on thiscriterion, who is able to receive Medicare Part A is narrow. One must besixty-five, which is when one becomes automatically enrolled in Part A.
Onemust also be receiving Social Security benefits. One can also be undersixty-five, but must be disabled (Reid, Deb, Howell, Conway, & Shrank, 2017). MedicarePart B is similar to Medicare Part A in that it is also run directly byMedicare. Furthermore, it is also referred to as, “Original Medicare,” by some.In actuality, Medicare Part B was split from A, allowing A to compensate forhospital related issues, while Medicare Part B focuses specifically onproviding medical coverage to its recipients (Doyle, Ettner, & Nuckols, 2016).These benefits are wide ad varied.
Medicare Part B can offer coverage andbenefits for different types of therapy, including speech, occupational, andbehavioral. It also covers any necessary screenings for suspected illnesses anddiseases, and allows for clinical lab services and routine check-ups with aphysician. Part B covers home healthcare for recipients, as well as outpatientand preventative care (Marmor, 2017). Arguably, MedicarePart B offers the first and most important line of defense concerning combattingillness while providing health awareness until one considers Medicare Part C. Similarto Part A, one must be sixty-five to receive Part B’s benefits, and mustalready receive Social Security benefits, or be under the age of sixty-five andhave a disability. One is automatically enrolled in Part B at the age ofsixty-five, and will receive a card representing your coverage three monthsbefore that birthday (Marmor, 2017). MedicarePart C is similar to Part A and B because it combines the two parts to create amore comprehensive health plan for those who need it, however it is oftenmanaged by private insurance agencies, rather than Medicare itself.
Thesecompanies do operate within Medicare approved contracts (Doyle, Ettner, & Nuckols, 2016). Commonly knowntoday as Medicare Advantage, Medicare Part C is another way for applicants toreceive Medicare services, but it is also more reliable concerning one’s healthas it allows for the recipient to receive full coverage during hospital relatedevents and other illness and health issues that may be less serious, but stillexpensive and necessary. In some cases, Part C also includes Medicare Part D,which is referred to as the Medicare Advantage Prescription Drug Plan. This, ofcourse is the most comprehensive plan Medicare offers, allowing for recipientsto enjoy every possible benefit presented by the health plan. In many cases,when Part C combines all parts of Medicare, it is reserved for individuals whohave become permanently disabled, the elderly, and in some cases those who arerecovering from a disability but are expected to work again (Reid, Deb, Howell, Conway, & Shrank, 2017). Disabilities canrange between mental and physical in nature, and must be assessed under greatscrutiny by a physician within the Medicare network to assess whether theindividual is eligible for Part C, or Part C with the combination of Part D. Theeligibility for Plan C is much different than that of A and B. One must livewithin Part C’s service area, not be suffering from End-Stage Renal Disease,and be a citizen of the United States (Marmor, 2017).
It is typical forindividuals to sign up for Part C during the initial enrollment period, whichis at the age of sixty-five, or when Social Security benefits are drawn, butnot everybody does this. MedicarePart D, as stated above, is Medicare’s prescription drug program. It offerscoverage on patient’s prescription drugs and can be combined with Part C, orcan be used as a stand-alone plan that is not used with any other insurance.
Unlike the other plans, Medicare Part D can be coupled with insurance plansoutside of the Medicare network (Marmor, 2017). Unsurprisingly,Part D covers the cost of the patient’s prescription medications. Some prescriptionsmay be free, though normally the plan simply lowers the price, howeversignificantly, and often helps maintain a steady price, protecting from futureprice hikes the patient would otherwise be unable to afford. If a person iseligible for any other Part of Medicare, they are eligible for Medicare Part D (Reid, Deb, Howell, Conway, & Shrank, 2017). Similar to Part C,many sign up for Part D at the age of sixty-five or when they draw SocialSecurity benefits, though many also use Part D sooner due to disabilities. Insum, Medicare in all of its parts is essential to the health and wellness ofits beneficiaries.
Typically offered to the elderly, and often automaticallygiven to them after drawing benefits or turning sixty-five, it is clear whileMedicare was instigated to begin with. Individuals with disabilities are stillable to take advantage of what Medicare has to offer during enrollment periods,though they may fair better under Medicaid’s plans, as this offers morecomprehensive plans for those needs. While Part A, B, and D can operateseparately, Part C can combine two or each of the parts in an effort to giveeach recipient everything necessary to live a full, health life at a reasonablecost.