Medicare refers to the national social health insurance program that the federal government of the United States of America offers to senior citizens. According to statistics, it offers coverage to 49 million people in the United States.
However, for people who have just turned 65, the process of signing up for Medicare can be quite complicated. It involves complicated terms, which you might not easily understand. Some of these terms include:
This is perhaps the most important term when it comes to Medicare. It refers to the agreement that in case you need any kind of medical treatment, your doctors, and suppliers will be directly paid by Medicare.
This term is more commonly used in the case of original Medicare. If you are instead enrolled in the Medicare advantage plan (offered by private companies), you will have to identify doctors who offer coverage under this program.
The original Medicare consists of two parts:
- Part A covers hospital insurance
- Part B involves routine checkups and visits to the doctors.
There are certain areas that the original Medicare plan does not cover. Coinsurance refers to the amount that you will have to pay out your pockets after all the deductibles. Usually it is twenty percent of the cost of services.
You might want to know that if you have Medigap, it will cover this additional amount for you. However, unlike Medicare, Medigap is offered by private organizations and all of these companies have different criteria when it comes to Medicare.
This refers to your share of the amount that you need to pay for visiting the doctors or for buying a particular medicine.
It is a fixed amount unlike coinsurance, where the amount you pay is determined in percentage terms. The amount you pay depends on the plan you are enrolled in.
Creditable drug coverage
Some people who decide to enroll in Medicare after they turn 65 also prefer to continue with their group coverage. If you are one of those people, you might want to make sure that your group coverage is “Creditable”.
Creditable means that the coverage that you receive is good or better than the drug coverage that you receive as a part of the Medicare program.
You might have to pay fines and penalties in case your group coverage is not creditable.
Medicare approved amount the money that your doctor receives when he or she treats you. This amount might be lower than what the doctor normally charges. In this case, Medicare will pay a certain amount while you will have to pay the rest.
As mentioned previously, Medicare terminology can be quite complicated. In such cases, health insurance brokers can prove to be helpful. Get in touch with us. We provide Medicare help and offer insurance brokering services in Raleigh, NC.
Contact us at 800-619-4450.