What you need to know about Medicare

Medicare is administered by the US Federal Government and you must be 65 years old or disabled to receive benefits. Medicare doesn’t pay all of the costs associated with doctor visits or hospitalization and you must pay a deductible each year before Medicare starts to pay on your medical claims.

Persons with certain disabilities and people of all ages with end stage Renal disease are eligible for Medicare.

Medicare comes in two parts with hospitalization being offered with no premiums. If you want Medicare to cover doctor office visits and lab fees you will have to pay for Part B.

*Part A for hospital coverage for which there is no premium

*Part B for medical services such as doctor office visits and out patient care.

Other services like in home care giving and certain ergonomic appliances or supplies are included in Part B. For example, if you need wheel chair or a scooter to ambulate, Medicare will pay part of the cost of these items if you doctor writes a “Medical Necessity” letter for the patient.

Husbands and wives benefit when one is on Medicare and the other works and has insurance in the workplace.

The working spouse will hold the primary insurance status for himself, while the spouse on Medicare can claim Medicare as the primary insurance and the spouse’s insurance as the secondary policy. In this situation the working spouse’s insurance pays after Medicare has paid its share of the claim.

Typically, Medicare pays 80 percent of patient claims and they have an established limit of what they’ll pay for each medical procedure. Patients with large medical expenses may opt to take on a supplementary insurance policy to defray the large costs.

Medicare deductibles have risen sharply with each progressive year for the past five years. If you want to know the current deduction your doctor’s office can give that information to you.

Prescription Drug Coverage. This is new to Medicare. A monthly premium is paid for this plan. The purpose of this plan is to lower costs of prescription drugs which can be useful for patients who otherwise spend three to four hundred dollars on prescription drugs. Recipients of Medicare can also opt into Walmart’s $4 dollar prescription plan.

Reports from the media tell a disturbing story of Medicare abuses within the system. Some hospitals and other Medicare providers are gaming the system and lining their pocket with Medicare funds. This is a wide scale problem that is now coming to light.

“A report by the Government Accountability Office, obtained Thursday by The Associated Press, examined roughly 436,000 providers who received government payments in 2006 for treating Medicare patients. It found that more than 27,000, or about 6 percent, owed the federal Treasury back taxes.” -International Herald Tribune

The future of Medicare is tied to the future of the Social Security system. If Universal Health Care becomes a reality, there are many options for implementation. It’s possible that the two systems would merge. It is important to keep abreast of the situation.

If you need specific information om Medicare benefits and eligibility requirements you’ll find them at the official site at Medicare.gov.