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What is Medicare Insurance?

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  • Written By: wiseGEEK Writer
  • Edited By: O. Wallace
  • Last Modified Date: 13 August 2018
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Medicare insurance may have several definitions. The first of these is that Medicare is a US government sponsored medical program for which most people 65 or older, or permanently disabled may qualify. People often qualify by working most of their lives or by being married to someone who has.

This insurance covers some of the costs of medical care including hospitalization and doctor visits, but has certain deductibles in place and does require most people making above poverty level income to pay a premium and make coinsurance payments. Some of the major parts of this insurance include Part A (hospital) and Part B (medical). People will pay premiums for Part B, whereas Part A is usually offered for free to any qualifying party.

What makes matters somewhat more complex is that there are insurance companies that work with Medicare insurance to possibly extend coverage or reduce deductibles and coinsurance payments. These are not offered by the US government, but the companies that offer these plans often have to be licensed or approved by the US in order to work with recipients of Medicare. There are three different types of Medicare insurance from private organizations that may be offered in conjunction with Medicare.

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Two different kinds of Medicare insurance that may change the way Medicare pays for medical costs are Medigap and Medicare advantage insurance. These policies are generally voluntary. Medigap usually requires an extra fee over the normal Medicare premium and may cover more of coinsurance payments or deductibles. It may also provide services not covered by the normal Medicare insurance.

An alternative to this is Medicare advantage insurance, which people also will pay a small to large premium for, over the Medicare Part B premium, and they might with this insurance enroll in a health maintenance organization, a preferred provider organization or other forms of insurance. Advantage plans may additionally have prescription drug coverage. Some of these plans may lower costs and especially might change the way care is received. People could be limited to seeing plan providers, and they might make copayments instead of coinsurance payments. Other services can be limited too, but it really depends on the plan; the coverage can also be better than what Medicare offers.

A third type of Medicare insurance is called Medicare Part D or prescription drug coverage. This is usually insurance that is provided by private insurers, and may not be required if people have a Medicare advantage insurance plan. There are many such plans to choose from, and a regular yearly enrollment period. Enrollment in Part D may be required or optional depending on other plans people participant in, or if they have retired from certain industries or state agencies.

A good way to find out more about Medicare insurance is to visit the US Health and Human Services website. There are many booklets, glossaries, and other informative pages that can help people understand all the ways in which Medicare may be understood. Another excellent resource is the AARP, which spends considerable time assisting its members in understanding the complexity of the Medicare system.

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