Medicare - Highland Health Insurance

What Is Medicare?

One of the most common topics that comes up in the insurance world is Medicare. Doctors, patients, and healthcare providers alike make reference to it. Still, many folks aren’t exactly sure what it is.

Put simply, Medicare is a federally sponsored healthcare program in the United States for people that are 65 years old or older (there are certain younger people with disabilities that also qualify for Medicare).

It began in the 1960’s, as a branch of the Social Security department, and provides health insurance for people who have worked and paid into the system via payroll tax.

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What Does Vision Insurance Cover?

Vision insurance covers things like eye exams and prescription lenses (and contacts). To a lesser extent, sometimes vision insurance will even give discounts towards corrective surgeries like LASIK. Obviously, plans differ, so make sure you read the coverage limits carefully.

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The 4 Parts of Medicare: A, B, C, and D

There are 4 commonly-known parts of Medicare, each with a different scope and purpose.

Part A: Covers inpatient hospital stays, expert nursing and hospice care
Part B: Outpatient services
Part D: Covers prescription drugs

Part C is less-common and a bit complex, but allows patients to elect plans with equal or greater benefits than those of Part A and Part B, as well as an out of pocket spending limit.

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Medicare vs. Medicaid - What’s the Difference?

People frequently confuse Medicare and Medicaid, simply because they are both federally-sponsored programs, with similar sounding names. While this may be true, they are two completely different programs, that serve different people and exist to do different things.

Medicaid is the federal program that helps to cover medical costs for people with limited income and resources. So it isn’t related to age or medical complexity, like Medicare is.

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What Are The Pros and Cons of Medicare?

Like most things in life, there are both pros and cons to the Medicare picture.

Pros:

Provides coverage to those that otherwise wouldn’t have it. This is the biggest pro, and indeed the reason for having Medicare in the first place. It’s affordable for participants. Expense related to Part A are covered, and those of Part B cost very little. Has spurred prescription innovation. Increased access to prescription medications naturally brought increased demand. In turn, this has motivated drug companies to develop and test more prescription medications. It has increased medical standards. With more federal money being dedicated to healthcare, more reporting was required by the government, which has increased awareness of inefficiencies and poor practices.

Cons:

Expensive to administrate. In 2016, Medicare administration cost 588 billion dollars (which was 15% of the overall federal budget). Attracts fraudulent doctors. Unfortunately, anytime there is a program that is offering to foot the bill for expenses, the expenses seem to materialize out of thin air. With assurances of being paid, some doctors take advantage of Medicare, by extending or recommending non-essential treatment. Costs taxpayers an enormous amount. Both employer and employee foot the bill for Medicare out of payroll tax.

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Do I Need Medicare Supplement Insurance?

Perhaps you’re concerned that you Medicare might not adequately cover your healthcare needs, or those of your family member. Depending on your situation, it may be a good idea to secure additional healthcare coverage. At the very least, it’s always wise to make sure that you understand your options.

Highland Health Insurance has a team of experts standing by to assist you with formulating a thoughtful healthcare plan. Contact us today, and in just a few minutes, we can acquaint ourselves with your situation, and share our best recommendations.

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