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NJ Senior Health
A Brief Explanation about the Four Parts of Medicare
Medicare, which is a four part health coverage program provided by The United States Federal Government, is available to most American citizens age 65 and over.Â Some people under the age of 65 who are disabled and some people at any age with end-stage renal disease may also qualify.
Here is a brief look at the four parts:
- Part A provides hospital, hospice and limited home health care coverage. It is free to eligible citizens 65 and older who, either themselves or their spouse, have paid Medicare taxes for 40 or more quarters. Anyone who already receives or is eligible to receive Social Security or Railroad benefits but hasn’t yet filed for them, is eligible for Part A. Other citizens or lawfully admitted aliens who have lived in the U.S. for at least five years can pay a monthly premium.
- Part B, administered by the government, covers medically necessary doctor visits, outpatient services, lab tests, x-rays, rehabilitation and physical therapy services, and medically necessary medical equipment. Under this plan, you can go to any doctor you choose. The current monthly premium for people earning $82,000 or less per year is $96.40 and there is an additional co-pay of 20 percent of the cost of the services covered. (Monthly premiums go up to $238.40 for those earning above $205,000 a year.) Eligible seniors can sign up for Part B within a seven-month period that begins three months before they turn 65. You can enroll by calling Social Security at 1-800-772-1213 or visiting or calling your local Social Security office.
- Part C is the Medicare Advantage Plan — an optional plan administered by private insurance plans and substitutes for coverage under Part A and B. This plan is less costly than Part B, but because it restricts one’s choice of doctors and service providers, it is important to be sure that the service providers covered are accessible and meet your needs.
- Part D is an optional prescription drug coverage plan. There are many choices of plans, and they each have different monthly fees, yearly deductibles, and co-pays. In addition, all plans fit into a complex system under which after a certain amount of coverage, there is a gap in coverage up until another level is reached. Different plans cover different medications, so you need to check each plan to see which one covers the medications you are currently taking. At a certain time each year you can switch plans in case your medication needs change or you are unhappy with your current plan.
Posted by: Frank Esposito, Vice President of Expert Home Care.Â New Jerseyâ€™s Expert Home Care provides professional and reliable home health care and companion care for NJ seniors, helping them with their daily living activities since 1984. Please call us toll free at 800-848-2336 when you have elder care related questions or need assistance for a loved one.