Medicare is one of the government funded federal healthcare programs available. It provides insurance for citizens who meet specific criteria, namely those who are aged 65 and over, people under 65 who have certain disabilities, and people who have End-Stage Renal Disease, which is a form of permanent kidney failure which requires constant dialysis or an organ transplant.

The Medicare insurance program is divided into four parts:.

Part A – Hospital Insurance

This part of Medicare is specifically to cover:

  • Inpatient care if admitted to hospital
  • Skilled Nursing Care, if placed in a skilled nursing facility
  • Terminal/End of life hospice care
  • Home based health care

Part B – Medical Insurance

Part B of the Medicare program is designed to cover:

  • Doctor or other healthcare providers services
  • Any outpatient care which may be required
  • The provision of Durable Medical Equipment (DME). Durable Medical Equipment is classified as:
    1. Equipment used to serve a medical purpose;
    2. Equipment which in the absence of illness, disability, or injury would not be of use
    3. are ordered or prescribed by a physician
    4. is reusable and can stand repeated use

Part A and Part B are considered the Original Medicare programme. Usually, if you or your spouse has paid Medicare taxes whilst working there will be no monthly premium for Part A, however there is the option to pay a premium for Part A if this does not apply to you. Often most people will have to pay a premium for Part B.

Part C – Medicare Advantage

Part C will cover:

  • All of the services provided in parts A & B
  • Will usually cover prescription drugs (Part D)
  • Is run by private insurance companies who are approved by Medicare
  • Other benefits may be included at an extra cost

Part D – Medicare Prescription Drugs Coverage

Part D of Medicare can:

  • Help cover the cost of prescription drugs
  • May help lower the price of prescription drugs and prevent it from rising in the future
  • Is run by private insurance companies who are approved by Medicare

Parts C and D will involve some form of premium to be paid by the patient, with some government subsidy.