Put simply, Medicare is a Federal Government health insurance program available in all states - South Dakota included. Medicare began in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services. It is a federal health program for people 65 years of age or older and people under 65 who have a disability. Some people with end-stage renal disease may also qualify for Medicare. The ages and reasons that someone may be eligible for Medicare can vary, so it is important to research this carefully.
2 Parts Of Medicare
Medicare is broken down into two different parts, Part A and Part B. Part A is hospital insurance. It covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health care. Part B is medical insurance. It covers services such as office visits to doctors and other health care providers, outpatient care, home health care, durable medical equipment like wheelchairs and walkers, and many preventative services. To enroll in Part A and Part B, you can do so through the Social Security Office.
Other Parts of Medicare
There are some medical services that neither Part A nor part B cover. To make up for some of these costs, you can also purchase Medicare Supplements. If you have only Part A and Part B and no other coverage in place (A Medicare Supplement or a Medicare Advantage Plan), this is called Original Medicare.
In addition to Medicare Supplements, there is also Part C and Part D. Part C is also known as Medicare Advantage. Medicare Advantage is offered by private companies that Medicare has approved. The Advantage plan is basically a bundle that offers Plan A and Plan B together. It sometimes also includes Part D, the prescription drug plan. To enroll in anything other than Part A and Part B, you need to do so through a private insurance agent or agency.
When Am I Eligible For Medicare?
- Sixty-five years or older and a U.S. citizen or a permanent resident for the previous five years.
- Some people with disabilities who are under the age of 65.
You also qualify if:
- you're getting Social Security or Railroad Retirement benefits,
- you're eligible for Social Security or Railroad Retirement benefits, or
- you're the spouse or dependent child of someone who meets either requirement listed above.
What Medicare Does NOT Cover
While Medicare covers many important services, you should make sure you know what is not covered. The following is a list of items not covered by Medicare:
- Massage Therapy
- Cosmetic Surgery
- Routine Dental Care
- Routine Eye Care
- Medical Care Outside of The United States
- Hearing Aids
- Long-Term Care
Know Your Rights
There are certain rights you have once you are eligible for and enroll in Medicare. It's crucial that you know your rights so you can be the best advocate for yourself. Your health is one of the most important things you need to deal with. Listed below are some of the fundamental rights you have and should be aware of.
- You have the right to be treated with dignity and respect at all times.
- You have the right not to be discriminated against. Every single company that works with Medicare has to abide by this rule. They are not allowed to treat you differently due to age, race, color, religion, national origin, disability, or sex.
- You have the right to privacy. Your personal and health information will not be shared.
- You have the right to receive healthcare in the language that you understand.
- You have the right to appeal a claim if you disagree with the decision.
- You have the right to file complaints or grievances about the quality of your healthcare.
Medicare Doesn't Have To Be Confusing
There are many different parts of Medicare, and all of the terminologies can sometimes be confusing. We hope to continue offering information to you in a way that's informative but also easy to understand. Medicare can be an excellent option for healthcare, especially if you know how it works and you're aware of your rights.