Medicare Program

The Medicare Program Provides
Health Care Assistance to Senior Citizens

After retirement from the service, Mr. Samuel Butler started seriously contemplating enrollment in a Medicare program. A senior citizen at 65, Samuel was finding it difficult to manage the rising health care expenses with his retirement benefits. Several ailments requiring frequent health care treatments was becoming expensive.

Samuel's wife Mary was suffering from an End Stage Renal Disease (ESRD) and his son Bill was disabled and using a wheel chair as a result of a severe car accident. After a lot of thinking, Mr. Samuel Butler had decided that a Medicare program would be the best solution for the medical problems faced by his family.

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Mr. Butler was correct in his assessments. As a matter of fact, his entire family was eligible to be covered by the Medigap program. Wife Mary would be covered by part B of the Medicare program and son Bill could be covered by the Medicare program as well.

The Medigap program, a federal health insurance plan, was introduced in 1965. It covers three types of clients.

The first category that a Medigap program covers is any citizen who is 65 years in age or above who has worked for forty quarters or ten years.

The second category covered by the Medigap program is the patients who are below the age of 65 but are suffering fro m End Stage Renal Diseases (ESRD).

A third category coming under the aegis of the Medicare program is those citizens who suffer from serious physical or mental disabilities.

The Medicare program is authorized under Title XVIII of the Social Security Act. A Medicare program is divided into four parts: -

Part A – Hospital Insurance.
Part B – Supplementary Medical Insurance.
Part C – Medigap Advantage Program.
Part D – A voluntary outpatient prescription drugs benefit.

Part D is authorized by the Medigap Prescription Drug, Improvement, and Modernization Act of 2003.

Under Part A of the plan, the Medigap program offers in patient hospital services up to 90 days per illness. The Medigap program also provides for skilled nursing facilities and home health care up to 100 day per illness following three days or more of hospital stay. In addition, an inpatient 190 days of psychiatric care is provided by the Medigap program.

Part B covers physician's services, durable medical equipment, out-patient hospital services, medical equipments, and all outpatient health related services. A very important part of coverage under the Medicare program is that it provides support for home health care not preceded by a hospital stay. There are also provisions for preventive services and blood work.

Part C and Part D of the Medigap program provides participatory beneficial plans for the patients.

This means that the entire family of Mr. Samuel Butler can benefit by enrolling in the Medicare program.

Medicare programs at times can be costly to the patient because the cost-sharing requirements required of the patient. This cost sharing problem can be addressed by joining certain supplemental health insurance packages like the Medigap, Medigap, employer sponsored coverage, Medicare HMO or Medicare Advantage plan. In addition, the Medicare program may be supplemented with other health insurance packages available to neutralize the onus of out of pocket expenses.

85% of the Medigap program beneficiaries receive Part A and B services through "free-for-service" Medicare. The Medicare program covers only a share of Medicate approved cost while the beneficiary is responsible for the remainder of expenses. Under Part A of the plan, each beneficiary has a $952(2006) deductible to enter a hospital. Use of a trained nurse is limited to approved healthcare days.

Part B of the Medicare program's beneficiaries have an annual deductible of $124 in 2006. Most of these Part B services require that at least twenty percent of the Medigap Approved Amount should be the responsibility of the patient.

An advantage of the Medicare program is that there is a managed care option that is available. This option will provide for almost all health care services. A fixed sum is paid by Medicare (the government) to a Medicare Advantage Plan (HMO) each month for each beneficiary.

Income and expenses related to Medicare program are managed through the Medicare Hospital Insurance (MHI) Trust Fund for Part A and through Supplementary Medical Insurance (SMI) Trust Fund. Almost the entire cost of health care expenses for Part (A) can be met with financial support derived from the Medicare program; it covers approximately 75% of expenses of out-patient health care expenses under Part B of the Medicare programs. The benefits for those who are enrolled in Part C are paid by MHI and SMI Trust funds together and Part D of the Medigap program are administered by the SMI Trust fund.

Rising health care costs has forced millions of Americans to seek coverage in health insurance plans or other Medicare programs. Worst hit by the rising costs are the vulnerable sectors of the society that includes senior citizens, patients having End Stage Renal Diseases, and those who are physically disabled.

Since the Medicare program is backed by federal legislation, the program is guaranteed. Many Americans, who do not have health insurance coverage, may benefit by enrolling in the Medicare program.

If you are over 65 years old, have End Stage Renal Disease, or physical disability, you may find the valuable information on this web site that will help you to meet your health care expenses. The Medicare program's information on this web site is our service to you and we hope that you will avail us for additional information when you select a supplemental to basic Medicare.

We know this industry and our knowledge will help you make a good decision when choosing a supplemental to traditional Medicare. The affordable supplement premiums and cost sharing options that we are knowledgeable of in will be of great benefit to you. There are many options available which may seem confusing and complicated.