How Does Medicare Work?

What Happens Once You’re On Medicare?

In most cases, Medicare pays 80 percent of the cost of covered services.Medicare, established in 1965, is a US federal government program providing health insurance coverage to Americans 65 and older, people under 65 with disabilities, and individuals with end-stage renal disease.  Your initial enrollment signs you up for Original Medicare (Medicare Part A and Part B), which provides the foundation of your Medicare coverage.

Medicare Part A

Pays for inpatient hospital services, skilled nursing facility care after a hospital stay, home health care, and hospice care. For further details about Part A coverage, click here.

 Medicare Part B helps pay for medical expenses, clinical laboratory services, and outpatient hospital treatment.

Covered medical expenses include physicians’ services and supplies. Some Medicare Part B services are paid as a fixed copayment under the outpatient prospective payment system.
Medicare Part B also pays for some preventive services including screening tests, flu shots, and vaccines covered by Medicare.

For further details about Part B coverage, click here coverage.
Once you enroll in Medicare, you’ll be subject to premiums, deductibles, copayments, and coinsurance. Here’s a brief reminder of what these terms mean:

Premium

A premium is a periodic payment, usually monthly, to Medicare, an insurance company, or a health care plan provider for health or prescription drug coverage. Medicare Advantage and Medicare supplement insurance plans vary from plan to plan and often from area to area. For information about Original Medicare premiums, click here coverage.

Deductible

Chances are you know all about deductibles. If you have homeowners insurance and you need to have your roof replaced from hail storm damage, you must pay a deductible, or a predetermined number of dollars, before your homeowners insurance will help pay for roof repair. It works the same way with Medicare. Your deductible is the amount you must pay for health care or prescriptions before Original Medicare or any other Medicare plan begins to pay. Some Medicare supplement plans will help pay for your Medicare Part A or Medicare Part B deductible.

Copayment

A copayment is the amount you may be required to pay as your share of the cost for a medical service or supply. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor’s visit or prescription.

Coinsurance

This is the amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%).
For a longer list of terms and definitions it may be helpful to know once you’re on Medicare, click here.

There’s a lot to know once you’re on Medicare.

That’s why MedicareMall is in your corner, ready to help in any way possible. With so many choices out there, MedicareMall will walk you through the Medicare maze and help you find the best health coverage possible. Contact MedicareMall now and we’ll work with you to ensure you get the coverage you need at a price you can afford.