Medicare and Senior Citizens
Medicare has become a given for senior citizens. They have no real choice. The money for Medicare is deducted your whole working life and at 65 you are enrolled into Medicare. You qualify as long as you qualify for Social Security.
Under certain conditions, your dependents may be qualified for Medicare, and you do not have to retire to get benefits. If you keep working you still must apply for hospital insurance for your Medicare protection to begin.
Part A covers in patient hospital services including:
Room and Board
Drugs and biologicals
Supplies, appliances, and equipment
Diagnostic and therapeutic items
Services of staff doctors
Services of interns, residents, and teaching physician
Treatments by a personal physician in or out of the hospital is covered under Part B.
Part A will also cover treatment in a psychiatric hospital for 90 days and in patients services at a participating skilled nursing facility.
Custodial care in a nursing home is not cover by Medicare but skilled care may be covered. Medicare will also pay for home health care under certain circumstances. The recipient of home health care must document the need for skilled services.
The rules for treatment under Part A are too long and complex to be discussed here, so a senior who is under Medicare should take the time to learn those rules that may apply to them.
Medicare Part B contributes to services performed by a personal physician. There are deductibles and coinsurance payments under both Parts A and B. The beneficiary must also pay a premium which may be deducted from his Social Security.
Again, the rules and regulations are extensive so if you are covered, you may want to learn those that concern you.
Part C combines Parts A and B and is delivered through a private insurance company. It is usually a lower cost alternative to A and B and also often includes Part D, prescription drug coverage. This is the so-called Medicare Advantage programs, that the Obama Administration is talking about eliminating. It is a very popular alternative for seniors and discontinuing it will be very controversial.
Part D is prescription drug coverage delivered through private insurers.
Medicaid provides health care coverage to the financially needy. Senior can benefit under Medicaid. You often will see custodial nursing home care services covered under Medicaid. There are both income and asset restrictions for coverage.
Some of this coverage may change under health care reform now proposed by the Obama Administration, and that has many senior citizens worried. They had to enroll in Medicare. They paid their entire work lives into it and they don't want to see benefits diminished.
The reality is that in the long term Medicare is financially unsustainable. The reason is there will be too many enrolled to be taken care of by the working population. Medicare funds were never invested into a trust. They were used as they come in and there will not be enough coming in. We, of course, do not know exactly when the system will bankrupt or how the Federal government will fulfill its promises to enrollees. Concerned citizens need to be aware and active in the future policy decisions that will affect their health care.