Medicare

Medicare, A Simple Explanation

October 24, 2019 • By

Reading Time: 2 Minutes

Last Updated: July 16, 2021

Social Security and Medicare are both programs that are household names, but do you know the true difference? Both programs help safeguard millions of Americans as well as improve the quality of life for their family and friends. While Social Security offers retirement, disability, and survivors benefits, Medicare provides health insurance.

Medicare is our country’s health insurance program for people age 65 or older and younger people receiving Social Security disability benefits. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care.

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare:

Original Medicare

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want drug coverage, you can join a separate Part D plan. To help pay your out-of-pocket costs in Original Medicare (like your deductible and 20% coinsurance), you can also shop for and buy supplemental coverage. Examples include coverage from a Medicare Supplement Insurance (Medigap) policy, or from a former employer or union.

Medicare Advantage (also known as Part C)

Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.  Part C plans may have lower out-of-pocket costs than Original Medicare.  They also may offer extra benefits that Original Medicare doesn’t cover — like vision, hearing, dental, and more.

If you can’t afford to pay your Medicare premiums and other medical costs, you may be able to get help from your state. States offer programs for people eligible for or entitled to Medicare who have low income. Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance. To qualify, you must have limited income and resources.

You can learn more about Medicare, including how to apply for Medicare and get a replacement Medicare card on our website.

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About the Author

Darlynda Bogle, Assistant Deputy Commissioner

Darlynda Bogle, Assistant Deputy Commissioner

Comments

  1. Frank G.

    I could almost live on what I pay for Medicare and insurance (BCBS) if house and car were paid for. Just wonder what my BCBS coverage would be without Medicare. Life goes on and you can’t live with it and can’t live without it in today’s world.

    • Luis A.

      Hi Frank. To discuss your private health insurance premiums, you need to contact your insurance carrier. You may also find it helpful to contact your local Medicare SHIP (State Health Insurance Program Coordinator) to discuss your health insurance options. You should also contact your state or local social services or welfare office. You may be eligible to receive social services from the state in which you live. These services include free meals, housekeeping help, transportation, or help with other problems. We hope this helps.

  2. Hospitals &.

    Medicaid Prices for All!! Medicare you may be b(k)illed letters are the primary reason for medical hyperinflation since the 1970s. Medicaid needs sell middle class and rich people premiums and charge insurance companies and uninsured patients reasonable Medicaid prices.

    Sanders, Tony J. Digestion. Hospitals & Asylums HA-30-10-19, 551 pp. http://www.title24uscode.org/digestion.pdf

    Humans require 0.7 to 3.7 liters of distilled or filtered water for drinking and cooking daily per person. The adult bladder holds about 400 mL of urine and the kidneys produce 1 liter of urine a day, from 4-6 liters of blood. Each 24 hours about 100-200 grams of stool is evacuated. Sedentary calorie requirements in the United States for children 2-3 years is 1,000 calories, children 4-8 years 1200-1400 calories. Girls 9-13 1600 calories. Boys 9-13 1800 calories. Girls 14-18 years 1800 calories. Boys 14-18 years 2200 calories. Females 19-30 years 2000 calories. Males 19-30 2400 calories. Females 31-50 years 1800 calories. Males 31-50 2200 calories. Females 51+ years 1600 calories. Males 51+ years 2000 calories.

    Good nutrition is the foundation of health and well-being for all. Everyone needs four basic nutrients – water carbohydrates, proteins and fats – as well as vitamins, minerals and other micronutrients. The human body is two-thirds water. Fatty acids are used by the body as a source of energy and are provided for in our diet by animal fat and vegetable oils that when metabolized supply 9 cal/g. Proteins, are complex chains of amino acids, supplied chiefly by animal proteins –meat, milk, cheese and eggs – and plants such as rice and legumes and nuts, that when metabolized yield 5 cal/g. Carbohydrates are complex compounds made up of sugars that when metabolized yield 4 cal/g. Protein and calorie requirements vary, with pregnant and lactating women, children, teenagers and young adults and strenuous exercise requiring larger amounts.

    Pregnant and lactating women in emergency settings should be provided with an extra liter of water and fortified blended food commodities, in addition to the basic general ration, that are designed to provide 10–12% (up to 15%) of energy from protein and 20–25% of energy from fat. The fortified blended food should be fortified to meet two thirds of the daily requirements for all micronutrients. Teenagers and young adults also require extra food. Cheese sandwiches. Beyond infancy a child requires about 10 percent of caloric intake in protein. Protein deficiency, especially during the first year of life, has been associate with decreased brain development and lowered IQ. The amount of protein in a mother’s breast milk is 5 percent of calories.

    According to the World Health Organization (WHO) the human minimum protein requirement is 5 percent of total calories, according to the US Recommended Dietary Allowance (RDA) for adults 10 percent of total calories. For optimum protein intake WHO recommends 10-15 percent of calories. Total fat intake should be less than 30 percent of total energy intake, Saturated fatty acid intake should be less than 10 percent of total energy intake. Trans-fatty acid intake should be less than 1 percent of total energy intake. At least 1 percent of calories should come from fat. Therefore, 55-75 to 94 percent of calories in the diet should come from carbohydrates.

    Calcium + vitamin D + phosphorus = Apatite. Bones and teeth contain 99 percent of all the body’s calcium and phosphorus, that is where the body gets it. For osteoporosis therapeutic and preventive measures should emphasize adequate intake of calcium (1500 mg/day), vitamin D (400-800 IU/day) and 1,000-1,250 mg/day of phosphorus.

    Exclusive breastfeeding – defined as the practice of only giving an infant breast milk for the first 6 months of life – has the single largest potential impact on child mortality of any preventive intervention. Together with appropriate complementary feeding, breastfeeding has the potential to reduce mortality among children under 5 years of age by 19%. Exclusive breastfeeding reduces the risk of gastrointestinal infection and of all-cause mortality, and protects infants from respiratory infections. Exclusive breastfeeding also has a protective effect against obesity later in life. Key recommendations are to improve maternity protection through the workplace (e.g. 6 months of mandatory paid maternity leave and polices to encourage women to breastfeed in the workplace), to empower women to exclusively breastfeed. The United States currently does not pay for 12 weeks of maternity leave, but protects the mother from wrongful termination of employment. A woman is entitled to 14 weeks paid leave Maternity Protection pursuant to ILO Convention No. 183 (2000). Six months is 24 weeks. There is now credible medical evidence that a woman should exclusively breastfeed for the first six months. WHO has specifically explained that this justifies 6 months mandatory paid leave. Therefore the unemployment compensation programs needs to estimate the costs of 24 weeks paid maternity protection based on the 6-months of exclusive breastfeeding ruling to update Maternity Protection ILO Convention No. 183 (2000) in WHO Essential Nutrition Actions: Mainstreaming Nutrition Through the Life-Course (2019).

    • Marc

      If you have insurance through a job or union membership, Medicare is secondary to that insurance, not the other way around. Medicare will pay part of what the job/union insurance doesn’t but not all of it. Once you retire or no longer have insurance through your job, Medicare will become primary and a supplemental policy (Part G or Medigap) would cover much of the rest, or you could switch to a Part C plan like your union plan.

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  6. jerry w.

    I am blind in one eye why cant I get help . medicare. I am 63 years old .I need help bad.

    • Luis A.

      Hi Jerry. Please contact Medicare regarding this issue. For more information on how other health insurance plans work with Medicare, or call the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227). You may also wish to contact your local Medicare SHIP (State Health Insurance Program Coordinator) to discuss your options. We hope this helps.

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