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When people hear the word, Medicare, they often believe it is one comprehensive healthcare plan, often only offered to the disabled and the underprivileged. While it does help those in need, as well as those who are unable to procure health insurance any other way, Medicare comes in several forms depending on the patient’s needs, as well as what the government and healthcare assessment deems necessary on the patient’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 own distinctions separating them from one another.
Medicare Part A it typically known as, “Original Medicare.” When most people think of what Medicare offers, and to whom they offer it, they are often thinking of the initial Medicare A package. Today Medicare A is represented by hospital coverage (Marmor, 2017). Managed by Medicare, it covered a variety of hospital-related visits and issues on behalf of the patient. For example, Medicare A offers covers and benefits for hospice and home health services, inpatient stays in a variety of skilled nursing homes, and inpatient hospital care for those who require it. Based on this criterion, who is able to receive Medicare Part A is narrow. One must be sixty-five, which is when one becomes automatically enrolled in Part A. One must also be receiving Social Security benefits. One can also be under sixty-five, but must be disabled (Reid, Deb, Howell, Conway, & Shrank, 2017).
Medicare Part B is similar to Medicare Part A in that it is also run directly by Medicare. Furthermore, it is also referred to as, “Original Medicare,” by some. In actuality, Medicare Part B was split from A, allowing A to compensate for hospital related issues, while Medicare Part B focuses specifically on providing medical coverage to its recipients (Doyle, Ettner, & Nuckols, 2016).
These benefits are wide ad varied. Medicare Part B can offer coverage and benefits for different types of therapy, including speech, occupational, and behavioral. It also covers any necessary screenings for suspected illnesses and diseases, and allows for clinical lab services and routine check-ups with a physician. Part B covers home healthcare for recipients, as well as outpatient and preventative care (Marmor, 2017). Arguably, Medicare Part B offers the first and most important line of defense concerning combatting illness while providing health awareness until one considers Medicare Part C. Similar to Part A, one must be sixty-five to receive Part B’s benefits, and must already receive Social Security benefits, or be under the age of sixty-five and have a disability. One is automatically enrolled in Part B at the age of sixty-five, and will receive a card representing your coverage three months before that birthday (Marmor, 2017).
Medicare Part C is similar to Part A and B because it combines the two parts to create a more comprehensive health plan for those who need it, however it is often managed by private insurance agencies, rather than Medicare itself. These companies do operate within Medicare approved contracts (Doyle, Ettner, & Nuckols, 2016). Commonly known today as Medicare Advantage, Medicare Part C is another way for applicants to receive Medicare services, but it is also more reliable concerning one’s health as it allows for the recipient to receive full coverage during hospital related events and other illness and health issues that may be less serious, but still expensive and necessary. In some cases, Part C also includes Medicare Part D, which is referred to as the Medicare Advantage Prescription Drug Plan. This, of course is the most comprehensive plan Medicare offers, allowing for recipients to 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 who have become permanently disabled, the elderly, and in some cases those who are recovering from a disability but are expected to work again (Reid, Deb, Howell, Conway, & Shrank, 2017). Disabilities can range between mental and physical in nature, and must be assessed under great scrutiny by a physician within the Medicare network to assess whether the individual is eligible for Part C, or Part C with the combination of Part D. The eligibility for Plan C is much different than that of A and B. One must live within 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 for individuals to sign up for Part C during the initial enrollment period, which is at the age of sixty-five, or when Social Security benefits are drawn, but not everybody does this.
Medicare Part D, as stated above, is Medicare’s prescription drug program. It offers coverage on patient’s prescription drugs and can be combined with Part C, or can 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 plans outside of the Medicare network (Marmor, 2017). Unsurprisingly, Part D covers the cost of the patient’s prescription medications. Some prescriptions may be free, though normally the plan simply lowers the price, however significantly, and often helps maintain a steady price, protecting from future price hikes the patient would otherwise be unable to afford. If a person is eligible 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 Social Security benefits, though many also use Part D sooner due to disabilities.
In sum, Medicare in all of its parts is essential to the health and wellness of its beneficiaries. Typically offered to the elderly, and often automatically given to them after drawing benefits or turning sixty-five, it is clear while Medicare was instigated to begin with. Individuals with disabilities are still able to take advantage of what Medicare has to offer during enrollment periods, though they may fair better under Medicaid’s plans, as this offers more comprehensive plans for those needs. While Part A, B, and D can operate separately, Part C can combine two or each of the parts in an effort to give each recipient everything necessary to live a full, health life at a reasonable cost.
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