Medicare: Know the Basics

Special Correspondent | Last Updated : June 21, 2022

What is Medicare?
Medicare is a health insurance program that provides coverage for medically necessary services. The purpose of Medicare is to provide financial help to eligible senior citizens, disabled individuals, and people with end-stage renal disease.

Eligibility Requirements Before You Enroll in Medicare.
1. To become eligible, you must be 65 years of age or older. The age requirement for Medicare is 65 years or older. You cannot enroll in Medicare at 18 years old or younger.

2. To be eligible for Medicare, you must be a U.S. citizen or an eligible non-citizen, as defined by federal law, two who have been a resident of the United States for at least five years before filing your application on the first day of the month in which you turn the 65 years old.
You are also required to complete Parts A and B of the Medicare program as listed below:

3. To be eligible for Medicare, you have to be disabled. If you have a physical or mental disability, you must also have been disabled with that physical or psychological condition for at least five calendar years.

4. To be eligible for Medicare, you have to file an application with the Social Security Administration and turn 65 years old during the issuance of your social security card or other document showing your name and age.

How To Apply for Medicare?
First, you must apply for a Social Security number or another document that shows your name and age. If you have no such document, you can obtain one from your state or local office of vital statistics. You cannot be turned down because of a prior application to Medicare.
You must apply for benefits with the SSA following federal law. The application must be filed by mail or through agency representatives in person at an office designated by the SSA.

The application must contain a detailed statement of the medical facts upon which your application is based and a notice of any decision reached by your physician as to any physical or mental condition which you claim is incompatible with employment, sufficient for filing Part A of Medicare.

Once you turn 65 years old, the SSA will issue a Medicare card. This card will indicate that you are now enrolled in Medicare. You will receive your first premium notice from the Social Security Administration about 60 days before your birthday. If your birthday is on or before December 31st, you will get this notice mid-September. Keep in mind that part A and part B in most cases does not cover dental implants, but you might able to find a coverage elsewhere.

Once you get your Medicare card and the first premium notice, enroll in Part B of the program and pay any applicable premiums by the due date shown on the information to avoid late payment penalties. One can prevent the early enrollment penalty fee if you have been without Part A and Part B of Medicare for less than three months before enrolling in Parts A & B.

As a beneficiary, you must submit a claim for each service or supply that you obtain. One must claim within 60 days of the date of service. For most services, you will prepare the claim form called Form CMS-1661 and submit it to Medicare as instructed on the form.

Medicare Part A is entitled Supplemental Medical Insurance; it covers inpatient hospital care, skilled nursing facility care, and other necessary services for your medical care.
Medicare Part B is entitled to Medical Insurance Benefits; it pays agreed-upon fees for medical services and supplies not covered by Parts A & B.

Pros of Medicare
1. The program is free to end-users.
It is sure to help you out if you ever need it. The most common benefit of Medicare is that it covers hospitalization. It pays for the services of doctors, nurses, and any other members of your care team who provide you with that medical attention when you need it.

2. It is a big help for the elderly.
Medicare is helpful for people who have had enough of working and can no longer perform their duties. It is useful in this group of people because they are at the regular age in many cases of the rest of us, which means they need extra care and attention.

3. It is helpful for those who are disabled with any condition.
Those who have a physical or mental condition preventing them from doing their job will benefit significantly from this program.

4. Medicare protects you from financial losses.
Suppose you are sick or injured, especially if you get medical care outside of the range of services offered by Medicare. The program provides peace of mind to people of all ages who are healthy today but may need health care in the future.

5. It is based on partnership.
The cost of Medicare is based on a partnership between the government and the beneficiaries. The beneficiaries pay a portion of their worth in premiums, and the government pays a bit by providing services free of charge.

6. It covers more services.
Medicare covers the cost of specific services not covered by private insurance, such as durable medical equipment, prosthetics, supplies, medical supplies for people with disabilities, medically necessary ambulance transportation, and Part B deductible copayments for each benefit period.

7. Medicare covers a wide range of providers and suppliers.
With Medicare, you can get care from the doctors, hospitals, clinics, and other healthcare providers that accept Medicare in your area.

8. You can stay in the hospital longer than people with private insurance.
Medicare allows beneficiaries to stay in the hospital for up to 90 days after their surgery or treatment without requiring them to sign a release of liability.

Medicare is a program that has been established to cover the costs of medical services and supplies incurred by beneficiaries. Since it is one of the largest healthcare insurance providers in the United States, you can use it as a support when you fall sick or get injured.

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