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How Does Medicare Work?

Medicare is a federal health insurance program primarily designed for individuals aged 65 and older, but it also covers some younger individuals with disabilities or specific diseases. It consists of four main parts:

  • Part A - Hospital Insurance: Covers inpatient hospital stays, care in skilled nursing facilities, hospice care, and some home health care.
  • Part B - Medical Insurance: Covers outpatient care, doctor visits, preventive services, and some home health care.
  • Part C - Medicare Advantage: A bundled plan that includes Part A, Part B, and usually Part D, offered by private insurers approved by Medicare.
  • Part D - Prescription Drug Coverage: Provides coverage for prescription medications through private insurers.

Enrollment in Medicare typically starts three months before the individual turns 65 and lasts for seven months. Individuals can choose to enroll in traditional Medicare (Part A and Part B) or opt for a Medicare Advantage Plan (Part C) which may offer additional benefits.

Medicare usually requires some out-of-pocket costs, including premiums, deductibles, and co-pays. However, many individuals can apply for financial assistance programs to help cover these expenses. Understanding how Medicare works is crucial for making informed healthcare decisions and managing personal finances effectively.

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