Source:myfederalretirement.com

Medicare Explained in 2021

Healthcare costs had been a significant concern in the United States for many years. Many US citizens cannot afford to get medical insurance or pay for medical bills, which leaves them in a dilemma when making decisions regarding their finances and health.

The government saw the health struggles that its people were going through and came up with a Medicare Program to secure American citizens’ health. The program provides quality and affordable health services for millions of American citizens.

Generally, MDC is a government health insurance plan regulated by Medicaid Services and the Centers for MDC. It is divided into different plans such as MDC part A, Part, part C, and Part D.

Let us delve deeper into the MDC parts and plans for better understanding.

Part A – Original Coverage

Source:sgu.edu

Once you apply for MDC, you get enrolled in Part A, also referred to as the original or hospital coverage. The plan covers your hospital admission, hospice, and professional nursing care for patients who need it after being ministered for occurrences that need rehabilitation in a medical facility before they recover fully.

Part A is somehow free, and you need not pay for a premium since it is already covered in your tax deductions form on your paycheck as MDC tax.

MDC caters to all hospital services for the first two months of hospitalization but does not cater for a private room.

Who is eligible for Part A original coverage? You are eligible for Part A original coverage if you are aged sixty-five and over or if your partner or spouse worked and paid for the scope for more than ten years. However, you can still get Part A coverage premium-free if:

  • You are entitled to acquire Railroad or Social Security benefits, but you are yet to file for them.
  • You or your spouse worked for the government, which catered for your original cover.
  • You are getting retirement benefits from Social Security or the Railroad Retirement Board.

You can still get Part A coverage if you and your spouse never paid MDC care taxes while working by buying it. If you are below sixty-five years, you can get Part A range for free if:

  • You are a kidney patient.
  • You qualify for Social Security or Railroad Retirement Board disability advantage for twenty-four months.

Part B – Doctor and Outpatient Services

Source:medicareresources.org

Part B’s program caters to doctor’s visits, medical equipment, laboratory tests, diagnostic screenings, ambulance services, and other outpatient services. Part B is more expensive than part A, and sometimes, people postpone signing up for the plan if they have work insurance or are covered by their spouse’s health scheme.

However, for people who don’t have medical insurance and are not covered in any way and still ignore signing up for part B, they are charged a higher monthly premium for as long as they first sign-up for the government medical program they stay in the scheme. You are eligible for part B MDC if you:

  • Are aged 65 years and above.
  • You are a US citizen, or you are a permanent lawful resident who has resided in the US for more than five years.

Part C – The Advantage

Source:boomerbenefits.com

The part C plan allows you to get Part A and Part B medical services from private insurance companies linked to MDC. For the impatient care, it covers everything under Part A with an additional home care service.

However, Part C has divergent cost allocation for inpatient care and healthcare compared to the original plan. The good thing is that hospice care in the plan C is covered by Plan A and B. For outpatient care, it substitutes for preventive services and medically essential services such as Occupational therapy, doctor visits, Emergency ambulance services, physical therapy, Lab test and x-rays, mental services, speech and language pathology, and preventive vaccines according to medicareusa.com. Plan C boasts of various advantage plans that include the following.

1. Health Maintenance Organizations (HMOs)

Employers cover it through an HMO Medicare Part C, and it boasts of provider networks that need you to approach the providers in the plans provider network for full coverage. It also asks you to choose a primary care provider and a referral when you need to see a specialist.

2. Preferred Provider Organizations ( PPOs)

Provided by some employer groups, and it typically has provider networks. It allows you to approach providers outside the provider network plan with higher charges. You can also choose a primary care provider and do not ask for referrals when visiting a specialist.

3. Private Fee for Service Plans (PFFS)

The plan comes up with its unique payment structure and settles on how much it will pay its providers and how much it will part with as a patient. It is a good pan as it allows you to visit any hospital that accommodates MDC assignment and PFFS payment terms. Even better, it does not ask you for referrals or to choose a primary care provider. As for the plans Copayment and coinsurance, you can only meet them service time.

4. Special Needs Plans (SNPs)

It is a unique plan that serves people suffering from certain health conditions or with exceptional qualifications. The program needs you to use providers specified in its network except in emergency and kidney dialysis cases. It also requires you to choose a primary caregiver and referrals to specialists.

5. Medical Savings Account Plans (MSA)

Source:medialogic.com

A unique plan that charges a lot of money from your deductibles in a separate bank account specifically for you, for your medical care coverage. The plan allows you to visit any hospitals that accept the government project. Sadly, it does not cover prescription drugs despite allowing additional coverages such as frequent dental and optical services.
Part C plans are cheaper than parts A and B, with additional benefits depending on the patient’s insurance company and individual plan.

MDC Part D

Part D covers prescription drugs, which you can sign up alongside your Part A and B coverage. Every MDC Prescription Drug Plan has a formula that lists the medications covered, which is available online. Part D requires you to pay a premium, accompanied by other costs that include coinsurance and copayments. However, the prices differ with different plans.

Part D coverage is optional, but it is advisable to enroll on it once you are registered for MDC to avoid late enrollment penalties when you decide to sign up for it later.

Choosing Your Ideal Medicare Plan

Thanks to MDC plans, millions of US citizens can today get affordable and quality medical care anytime they want, depending on the schemes they choose. If you’re not sure of which MDC plan to go for, you should consult a professional so that you can make the right choice and get enrolled on time.


Ricardo is a freelance writer specialized in politics. He is with foreignpolicyi.org from the beginning and helps it grow. Email: richardorland4[at]gmai.com