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Eligibility for Medicare
Medicare Benefits

Eligibility for Medicare benefits includes most people 65 and older. Eligibility also includes some younger people with disabilities or End-Stage Renal Disease (permanent kidney failure).

People covered by Medicare benefits are called beneficiaries. Medicare pays for much of their health care, but not all. For example, Medicare benefits cover most acute medical care — for conditions from which a patient usually recovers. But, eligibility for Medicare benefits doesn't cover most care given at home, in assisted living facilities or in nursing homes, for people with chronic disabilities and lengthy illnesses. And, for many people, there are large gaps in Medicare's prescription drug plans.

Medicare benefits are provided in 3 parts, A, B and D. Part A helps pay for inpatient hospital care, some skilled nursing facilities, hospice care, and some home health care. Part A is premium-free for most people. However, most beneficiaries do pay a monthly premium to be covered under Medicare Part B — the part that helps pay for doctors, outpatient hospital care, and some other care that Part A doesn't cover, such as physical and occupational therapy.

Medicare's Part D provides prescription drugs benefits. For more information, including how to enroll, click on Medicare Prescription Drugs benefit. Like Part B, most people have to pay extra premiums to be covered for prescription drugs under Part D.

Most beneficiaries are covered under the Original Medicare Plan. That plan requires beneficiaries to pay for some of their health care in addition to their monthly Part B and Part D premiums. Those additional amounts are called deductibles and coinsurance. Premiums, deductibles and coinsurance amounts change every year on January 1st. To see what they are this year, click on 2009 Medicare benefits.

You can purchase other insurance policies to cover part or all of Medicare's deductibles and coinsurance amounts, or to cover many types of care that it doesn't cover. These include:

Medicare Supplement (Medigap) insurance from a private insurance company. (Beginning January 1, 2006, the 12 standardized plans (in most states) will include NO coverage for prescription drugs. You must purchase a separate policy for prescription drugs.) For more information, click on Medicare Supplement Insurance for Seniors.

Employer or union coverage

Long-Term Care insurance

Other kinds of insurance

You don't need to buy Medicare Supplement insurance if you're covered under Medicaid, or if you're enrolled in a ...

Managed Care Plan (a Medicare HMO)

Private Fee-for-Service Plan

Medical Savings Account

Religious Fraternal Benefit Plan

There are more than 40 booklets to help people understand the program. To review the list,

click on eligibility for medicare, medicare benefits, eligibility for benefits

-- Medicare FAQs, Tips and Nasty Surprises --

Medicare often runs smoothly without a hitch. At other times, it can be very annoying — even downright frustrating. For some people, it is full of potholes that cost them thousands of dollars out of their own pockets. Bottom line — what you don't know can hurt you. For more information, click on Medicare FAQs, Tips and Nasty Surprises.

Latest 2010 Medicare Benefits Information

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