Medicare Near San Diego

What is Basic Medicare?

Medicare is a Federal Health Insurance program that covers most people 65 years old and over, some people younger than 65 with disabilities, people diagnosed with amyotrophic lateral sclerosis (ALS), and those with end-stage renal disease (ESRD).

Medicare is divided into several parts. These parts are:

Part A– Hospital insurance – Covers most in-patient hospital care, some in-patient skilled nursing facility care, some home health care, and hospice care. – There is no monthly Part A premium for people who have 40 or more quarters of Social Security credits (about 10 years of full-time work with four quarters per year) and who are eligible for Social Security or Railroad Retirement benefits.

Part B – Outpatient medical services – Covers a portion of the Medicare approved costs for out-patient medical services such as doctors’ services, out-patient hospital care, laboratory tests, out-patient physical and speech therapy, some home health care, ambulance services, and some medical equipment and supplies. – Monthly premium is $104.90 (in 2015) for beneficiaries with individual incomes of $85,000 or less.

Part C – Medicare Advantage plans
Part D – Prescription Drug plans

How to Find Out What Original Medicare Covers:

Talk to your doctor or other health care provider about why you need certain services or supplies, and ask if Medicare will cover them. If you need something that’s usually covered and your provider thinks that Medicare won’t cover it in your situation, you’ll have to read and sign a notice saying that you may have to pay for the item, service, or supply.

Medicare.gov is also a great resource. There you can find lists of covered services.

Medicare doesn’t cover everything. If you need certain services that Medicare doesn’t cover, you’ll have to pay for them yourself unless you have other insurance or you’re in a Medicare health plan that covers these services.

Some of the items and services that Medicare doesn’t cover include:

• Long-term care
• Most dental care
• Eye examinations related to prescribing glasses
• Dentures
• Cosmetic surgery
• Acupuncture
• Hearing aids and exams for fitting them
• Routine foot care

Even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments.