It is essential for one to take a proper decision on the type of the medical Plan offered by the Medicare that suits their preference. The different types of the plans cover your, hospital visit, initial hospital care, home care services, outpatient services, prescription drugs and much more with respect to the plan of your choice. As complicated as it may appear, there are some certain decision-making criteria that you need to know, are you attracted to the Original Medicare Plan that is operated by the federal government, which consists of Part A and B, or Medicare Advantage plan, referred to as Part C, provided by the private insurer. The following paper will discuss the four Medicare Plans available in the US that covers both the private and federal sectors.
Medicare Part A: Also referred to as Original Medicare, is the insurance plan that offers Medicare coverage and benefits for the hospice and home health services, inpatient hospital care together with the inpatient stays in various skillful facilities; all this is covered apart from the doctors fees. One would not likely to have to pay the monthly premium for this part. However, one is required to pay annual deductible prior to the Medicare coverage of any hospital costs. In 2011, the Part A deductible was $1132. For the first 60 days of hospitalization, Part A will cover nearly 80% of the Medicare approved inpatient costs. Although, for those who stay in the hospital for long, they will need to pay a larger part of the cost. In this case, one would need to have supplemental insurance. Those who are live in U.S as citizens or permanent residents, though, they have not worked much longer to be considered for Medicare, and at the same time they are unqualified to benefit through their spouses, they are allowed to but their Part A coverage (Cohen, et al. 2015).
Part B also referred to as Original Medicare is an insurance plan that offers Medicare coverage and benefits for Preventive and outpatient care, Clinical laboratory and doctor services, occupational and physical therapy, ambulance services, mental health services as well as the screening and surgical fees and supplement (Silbert-Flagg & Sloand, 2015). This part of insurance is optional, and one might decide to opt out if he/she benefits from other health insurance from the employer, spouse, union or any other insurance coverage. In order to subscribe to this plan, one is required to pay a monthly premium for Medicare (2011 standard rate was $ 115.40), together with the small deductible (2011 standard pay was $162), which must be fulfilled before starting to access the plan.
Medicare Part C: Also known as Medicare Advantage is an alternative means of accessing Medicare Part A and B coverage. Medicare Advantage (MA) Plan is a combination of both Part A (hospital insurance) and Part B (medical insurance) all in one plan. Also, the Plan can be joined with Part D covering prescription drug, therefore developing Advantage Prescription Drug Plan. Generally, the Medicare Advantage Plan has organized as provider organizations (PPOs) and health maintenance organizations (HMOs). The core idea of this type of a plan is that ones allowed to choose a preferred doctor as a primary health provider, while the choice of hospitals, doctors as well as other health providers is restricted (Cohen, et al. 2015).
Medicare Part D: is a Prescription Drug Plan (PDP) which is being considered as combined plan or a stand-alone plan with a Medicare Advantage Plan, also referred to as Medicare Advantage Prescription Drug (MA_PD) Plan. This plan helps in covering the prescription drugs. This part of a Plan is optional and people who are enrolled in Original Medicare can access it (Silbert-Flagg & Sloand, 2015). .
Decisively, depending on the choice of the plan that one might take, it is important to look for a particular plan that suits your financial standard and your health state. Those who have chronic diseases are advised to take a comprehensive cover like Plan C so that they can access emergency medical services. However, all the Plans are the best, but it all depends on your health demands and the amount of money that you are willing to give.
Cohen, A. B., Colby, D. C., Wailoo, K. A., & Zelizer, J. E. (Eds.). (2015). Medicare and Medicaid at 50: America's entitlement programs in the age of affordable care. Oxford University Press.
Silbert-Flagg, J., & Sloand, E. D. (Eds.). (2015). Pediatric Nurse Practitioner Certification Review Guide. Jones & Bartlett Publishers.
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