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Thursday 23 May 2013

Medicare elucidation with a summary of its parts A, B, C & D

Medicare is the national health insurance program, by the government for medical and health related services. These services are provided to the specific group of people. Medicare is administered by the Centers for Medicare and Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services. Since 1965, Medicare guarantees access to health insurance for Americans ages 65 and older and younger people with disabilities as well as people with end stage renal disease.


Medicare is providing services in four major parts. These parts are categorized according to the specific services in different sections of healthcare industry. These parts are known as A, B, C & D. Lets discuss each of them:
Part A: Hospital Insurance
  • Helps cover inpatient hospitals care
  • Helps cover skilled nursing facility, hospice, and other medical services
Part B: Medical Insurance
Part B includes other medical services & supplies that are not covered by Part A. It also helps the doctor to cater the medical bills from outpatient visits & care.
  • Helps cover doctors' and other health care providers' services, outpatient care, durable medical equipment, and home health care
  • Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse
Part C: Medicare Advantage
Part C covers the element of choice. This plan allows you to select to receive healthcare services through a provider organization. This works incredibly to reduce your costs of receiving medical services. To enroll in Part C, you must have both parts A & B.
  • Offers health plan options run by Medicare-approved private insurance companies
  • Medicare Advantage Plans are a way to get the benefits and services covered under Part A & B
  • Most Medicare Advantage Plans cover Medicare prescription drug coverage (Part D)
  • Some Medicare Advantage Plans may include extra benefits for an extra cost
Part D: Prescription Drug Coverage
This part of Medicare is voluntary & provides outpatient prescription drug coverage. Part D is only available through private insurance companies that have contracted with government.
  • Helps cover the cost of prescription drugs
  • May help lower your prescription drug costs and help protect against higher costs in the future
  • Run by Medicare-approved private insurance companies
Policies driven by Medicare help the private health insurance companies to utilize Medicare benefits & privileges. There are many Medicare plans like HMOs (Health maintenance Organization) or PPOs (Preferred Provider Organization). In general the benefits cover:
  • Payment  for Doctor Bills
  • Handling hospitalization charges/costs
  • Prescription Drugs
  • Settlement of other related medical services & products.
The meaningful use program by Medicare brings supplementary benefits in addition to the federal government financial incentives. It allows providers and practices enhance their services by reducing errors and quick access to information.


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