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Medicare is a federal health program instituted by an amendment to existing Social Security legislation in 1965. Medicare provides health insurance to people age 65 and over, people with certain disabilities, and people with End-Stage Renal Disease.
The Original Medicare Plan offers hospital insurance (Part A) and medical insurance (Part B). There are copayments or coinsurance amounts that you pay when you receive Medicare-covered services. You must meet a yearly deductible and pay a monthly premium for your Part B coverage. You can generally receive care from any doctor or hospital that accepts Medicare.
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In addition to the Original Medicare Plan, there are supplemental policies or private health plans that you can choose from.
Medigap plans are supplemental insurance policies run by private companies. These plans help you pay the coinsurance, copayments, and deductibles on services you receive through the Original Medicare Plan.
You may also choose to purchase a Medicare Part D prescription drug plan, which provides coverage for your prescription drugs. These plans are also administered by private companies. Most plans have a formulary, or a list of the drugs that are covered under that particular plan. Many plans have a network of pharmacies and will require you to use a network pharmacy in order to receive benefits.
Finally, there are Medicare Advantage Plans that combine all of your Medicare benefits under a single plan run by a private health company. These companies receive subsidies from the federal government to help pay for your care. You can choose from different plan types, such as HMO or PPO plans that coordinate your care through a network of service providers, or Private Fee-for-Service Plans that allow you to see any doctor that will accept your plan's payment agreement.
The different options may change the amounts of coverage that you have and may allow you to receive coverage for different services. Only you can decide which plan will work best, and regardless of what you decide, you will still be a part of the Medicare plan.
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* You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:
1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week;
The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or Your State Medicaid Office
Dental or vision options can be added to your
coverage.
Living longer means paying more for health care.
A woman who retires at 65 can expect to maintain her health until the age of 84, on average.2
Men who expect high health costs after they turn 65 end up retiring – on average – 13 months later than those who don't.3