Plans In Your Area
Your Guide to Medicare Insurance Coverage in 2020
What Is Medicare?
Medicare is a national health insurance program which began in 1966 by the Social Security Administration. Now part of the Centers for Medicaid and Medicare Services, the program is supported by a combination of payroll taxes, premiums, and surtaxes paid in by participants, formally known as beneficiaries.
Important Note: Although they sound similar, Medicare and Medicaid are two different programs, with the most significant difference being Medicaid is operated by the individual states.
Health insurance is provided to over 46 million people age 65 and older. The program also provides coverage for 9 million younger Americans. On average, Medicare pays approximately half or the health care costs for participants.
The coverage afforded under Medicare is provided under four sections named “parts.” In general, each part offers the following coverage:
- Medicare Part A – Covers inpatient hospital, skilled nursing care after three days of formally being admitted, and hospice care.
- Medicare Part B – Covers outpatient services which may include some services received while as an inpatient in a hospital.
- Medicare Part D – Covers prescription drugs.
- Medicare Part C – Also known as Medicare Advantage, provides coverages afforded under Parts A, B, and D.
When choosing Medicare Part C, your coverage will be provided through a private insurer, instead of directly through original Medicare.
Important Note: Medicare will only cover 80% of any specific medical cost, the remaining 20% is the responsibility of the beneficiary.
Where Medicare stops at 80%, individuals become responsible. Participants can pay the difference out of their own pocket or purchase a Medicare Supplemental Insurance Plan.
Who Qualifies for Medicare?
You’re eligible for premium-free Part A Medicare if you’re 65 or older and you or your spouse worked and paid Medicare taxes for at least ten years. You can get Part A at age 65 without having to pay premiums if:
- You’re receiving retirement benefits from Social Security
- You’re receiving retirement benefits from the Railroad Retirement Board
- You’re eligible for either of these benefits but have not yet filed for them
- You or your spouse had a Medicare-covered government job
If you or your spouse did not pay into Medicare taxes while you worked and you’re a permanent resident of the United States and are 65 or older you can get Part A without having to pay premiums if:
- You’re entitled to Social Security disability benefits for 24 months
- You’re entitled to Railroad Retirement Board disability benefits for 24 months
- You’re a patient of kidney dialysis or have a kidney transplant
(If you have Lou Gehrig’s disease, your Medicare benefits begin the first month you get disability benefits.)
While most won’t have to pay the Part A premium, everyone must pay for Part B if they want it. The cost will be deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If these payments are not applicable to you, Part B premiums will be sent to you by Medicare every three months.
Medicare Carriers
- Aetna
- Anthem
- Blue Cross Blue Shield
- Cigna
- Continental Life
- Manhattan Life
- Mutual of Omaha
- Transamerica
- United American
- United of Omaha
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