Health

Your Guide to Understanding Medicare

With thousands of providers delivering health care services under Medicare and millions of people using these benefits, Medicare is one of the best healthcare programs in the country But, understanding the basics of the program can be complex. 

This guide has been created to help seniors and their loved ones understand the basics and benefits of Medicare. 

Eligibility

Most people can qualify for Medicare programs if they are permanent residents or citizens of the United States, and they’re 65 or older. Those under the age of 65 years who have end-stage renal disease or are disabled can also qualify for Medicare. In such cases, benefits are provided after diagnosis. 

Enrollment

Those who receive any Social Security benefits once they turn 65 are automatically enrolled in Medicare. About 3 months before their 65th birthday, these people will receive information and enrollment cards. They can also sign up at any local Social Security office if they are not enrolled automatically. However, to ensure prompt coverage, the enrollment should be completed on-time.

Healthcare Providers

Medicare patients can go to any clinic, doctor, nursing facility, pharmacy, hospital, outpatient provider, or home care agency that is approved by Medicare and accepts Medicare patients. However, before visiting, it is important to verify that the provider or doctor accepts Medicare.

Medicare Coverage

Primarily, Medicare provides coverage if and when someone is injured or ill. This includes lab work, doctors’ services, hospice, X-rays, hospitalization, and every type of outpatient care. It also includes both inpatient and outpatient mental health care, along with inpatient nursing facilities. 

Now, Medicare also covers a range of screening and preventive services, which include smoking cessation counseling, cardiovascular screening, screening for different types of cancers, diabetes screening and supplies, a “Welcome to Medicare” physical exam, immunizations for flu, hepatitis B, and pneumococcal virus, and glaucoma tests. 

For those people who meet the requirements for home health care, Medicare also covers part-time health aides, medical supplies and equipment (like bandages and wheelchairs), part-time nursing care, and speech, physical and occupational therapy.