Federal system of health insurance for people over 65 years of age and for certain younger people with disabilities
Seguro médico del estado
You’ve probably heard about Medicare, so we’ll explain a little more about it. Basically, it is a federal program whose benefits are established for certain population groups. In the first place, we find all those people who are over 65 years old.
Medicare also admits people who suffer from a very advanced stage of kidney disease, who depend on treatments such as dialysis, or who are waiting for a transplant. Finally, this program is valid for young people who have some type of disability.
However, many of us are confused about how Medicare works. This article will give you a complete overview of this program and how it works.
Medicare Services
Like other types of medical services, Medicare has classifications for these services. These are the sections.
Hospitalization Insurance or Part A
In this case, Medicare can cover the type of care where attendance at a medical facility is required. For example, hospitalizations, skilled nursing facility care, and home health care.
Health insurance or Part B
Medicare will cover specific services in this case, which are related to any outpatient care, such as outpatient medical and preventive services and supplies.
Medications or Part D
Part D is a Medicare-only service whose primary purpose is to cover a portion of the costs of certain drugs prescribed by the doctor. A long list of vaccines is also included.
Medicare Coverage Plans
Medicare has a system through which you can choose the coverage option that best suits your needs, so you can choose between:
- Original Medicare Plan.
- Medicare Advantage Plan.
Original Medicare Plan
In this case, Medicare offers everyone the possibility of acquiring this plan, which includes hospitalization insurance or Part A and medical insurance or Part B. This modality will allow you to make payments for services only when you receive them.
Once you have enjoyed the benefits of the services, you will have to pay a fee at the beginning of each year, which most of the time represents 20% of the service’s total cost.
To obtain drug benefits or Part D, Medicare invites you to add to your service plan, which functions as an add-on or extra.
If you need to cover a higher cost of the services received, you can upgrade your plan with Medigap, which acts as an add-on plan.
Plan Medicare Advantage
In this plan, a private company approved by Medicare offers all the services of the original Medicare Plan, such as medical insurance, hospitalization, and drugs (in some cases), adding others.
For example, within Medicare Advantage, you will have the possibility of enjoying dental, hearing, and vision services, which are not reflected in the original plan.
Before requesting and using the services of this Advantage plan, it is necessary to understand that some expenses will not be covered. In addition, you must validate the main rules of use to obtain services in the most appropriate way.
Finally, contracts with this plan are made annually, and you must be notified in advance of any changes in the conditions.
