Social Security and Medicare
Providing Vital Benefits to Seniors
It’s understandable that Social Security and Medicare are linked in many people’s minds. One reason is that Medicare was created under Title XVIII of the Social Security Act. Another reason is that Medicare is financed in part by monthly premiums deducted from Social Security checks. But it’s safe to assume the main connection most Americans see between Social Security and Medicare is the fact that Medicare, like Social Security, provides vital benefits to seniors.
There were only two parts to Medicare when it was established by Congress in 1965, and Medicare Part A and Part B, often called Original Medicare, remain the foundation of Medicare coverage to the present day.
Enrolling in Medicare Parts A and B used to require a visit to the local Social Security office, but no more. Now it’s easy to apply for Original Medicare (or to find any Social Security information you may need) online by visiting the Social Security Administration website at ssa.gov. Although some people are eligible earlier due to disability, most Americans currently become eligible for Medicare benefits when they turn 65. For further information about eligibility and enrollment, visit ssa.gov or medicare.gov, or call MedicareMall toll-free at (877) 413-1556.
Congress introduced Medicare Part C (also called Medicare Advantage) in 1977. Medicare Advantage plans are optional Medicare plans offered by Medicare-approved private companies and available to people already enrolled in both Medicare Part A and Medicare Part B. Medicare Advantage plans can provide additional coverage in various areas of health including dental, vision, and hearing, and most plans also include prescription drug coverage.
Following are a few Medicare Advantage options:
Medicare Private Fee-for-Service (PFFS) Plans
Generally allow you to visit any doctor or hospital Original Medicare would allow you to visit, as long as the doctor or hospital agrees to treat you. A PFFS plan can require you to follow strict rules and determines how payments are to be divided between the PFFS and the patient.
Health Maintenance Organization (HMO) Plans
Normally require referrals from primary care physicians and treatment by specialists and hospitals within the plan’s network.
Medicare Preferred Provider Organization (PPO) Plans
Allow you to use doctors, hospitals, and providers outside the plan’s network at additional cost.
Medicare Special Needs Plans (SNPs)
Provide focused, specialized health care for specific groups of people including beneficiaries of both Medicare and Medicaid, those in nursing homes, and those with certain chronic conditions.
Medicare Part D was established in 2003 so that Medicare recipients could participate in federal subsidies to lower their prescription drugs costs. Medicare prescription drug plans (or Medicare Part D plans) pay some of the costs for prescription drugs at participating pharmacies. Everyone enrolled in Medicare Part A or Medicare Part B is eligible for Part D coverage, regardless of income and resources, health status, or current prescription drug expenses. The program is voluntary and can be especially helpful for people who have high prescription drug costs and no current prescription drug coverage. To receive Part D coverage, you must choose a plan offered by a Medicare-approved private insurance company and pay monthly premiums, deductibles, and co-payments.
If you have any further questions about Medicare, disability and Medicare, Medicare enrollment, or anything else connected with senior health insurance, MedicareMall is here to serve you. MedicareMall has been in the senior health insurance business for over 20 years, earning a reputation for excellence while addressing the unique needs of each of our clients. Whatever your needs and budget, MedicareMall will find the coverage that’s right for you. Don’t fall through the gaps in Medicare coverage. Contact us now and we’ll make sure you’ve got the coverage you need at a price you can afford.