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Medicare  
Basics


Do you know the difference between the “parts” of Medicare — Part A, Part B, Part C, and Part D? There are many important facts you need to understand about Medicare prior to enrolling to make sure you get the most out the available Medicare plans and benefits.


Medicare Overview
Medicare is a federal health insurance program that pays for a variety of health care expenses. It’s administered by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS). Medicare beneficiaries are typically senior citizens aged 65 and older. Adults with certain approved medical conditions (such as Lou Gehrig’s disease) or qualifying permanent disabilities may also be eligible for Medicare benefits.

Similar to Social Security, Medicare is an entitlement program. Most U.S. citizens earn the right to enroll in Medicare by working and paying their taxes for a minimum required period. Even if you didn’t work long enough to be entitled to Medicare benefits, you may still be eligible to enroll, but you might have to pay more.


There are four different parts to the Medicare program. Parts A and B are often referred to as Original Medicare. Medicare Part C, or Medicare Advantage, is private health insurance, while Medicare Part D offers coverage for prescription drugs. The details below tell you more about Medicare insurance plans, with an overview of the four parts.
The “parts” of Medicare

The types of Medicare programs are often referred to as Part A, Part B, Part C, and Part D. Here’s a rundown of what each “Part” is about.

Medicare Part A
Medicare Part A is hospital insurance. Part A covers inpatient hospital care, limited time in a skilled nursing care facility, limited home health care services, and hospice care.

Most Medicare Part A beneficiaries don’t have to pay a monthly premium to receive coverage under this part of Original Medicare; this is called “premium-free Part A.” Generally, if you’ve worked at least 10 years (40 quarters) and paid Medicare taxes while you worked, you’re eligible for premium-free Part A. Otherwise, you pay a monthly premium.

Medicare Part A typically doesn’t cover the full amount of your hospital bill, so you will probably be responsible for a share in the cost. You will also have to pay a deductible before Medicare benefits begin. Medicare will then pay 100% of your costs for up to 60 days in a hospital or up to 20 days in a skilled nursing facility. After that, you pay a flat amount up to the maximum number of covered days. Your Medicare Part A benefits cover some of the costs for a total of 90 days in a hospital and 100 days in a skilled nursing facility. Medicare also covers up to 60 “lifetime reserve days.” These are days you stay in a hospital longer than 90 days in a row. You get a lifetime total of 60 reserve days.

Medicare Part B
Medicare Part B is medical insurance. Part B benefits cover certain non-hospital medical expenses like doctors’ office visits, blood tests, X-rays, diabetic screenings and supplies, and outpatient hospital care. You pay a monthly premium for this part of Original Medicare. The fee can be higher for people with high incomes. A different government program, Medicaid, can help cover Medicare Part B premiums for low-income beneficiaries.

Medicare Part B beneficiaries are usually responsible for a portion of their health care costs. You’ll have to pay a deductible each year before your Medicare Part B benefits kick in, and then you’ll generally pay 20% of the bill when you go to a participating Medicare doctor. Medicare pays the full cost of many lab tests and services requested by your doctor.

Medicare Part C
Medicare Part C, or Medicare Advantage, insurance often includes every type of Medicare coverage in one health plan. It’s offered by private insurance companies contracted through CMS to provide a Medicare benefits package as an alternative to Original Medicare. Enrolling into a Medicare Advantage plan is optional, but to obtain this private insurance, you must also have Original Medicare, Part A and Part B. You also may have to continue to pay your Part B premium if you have a Medicare Advantage plan.

While Medicare Advantage plans are required to provide all Medicare Part A and Medicare Part B benefits (except hospice care), plans can also include different additional benefits, which vary among the individual private health insurers. Many Medicare Advantage plans include prescription drug coverage known as Medicare Advantage Prescription Drug plans. Some plans might have a lower deductible, while also allowing you to pay a smaller share of the remaining costs. Medicare Advantage plans may even cover certain health care services that Original Medicare, Part A and Part B, does not cover, like eye exams, hearing aids, dental care, or health care received while traveling outside the United States.

Medicare Part D
Medicare Part D is optional prescription drug coverage. Medicare Part D is available as a stand-alone prescription drug plan through private insurance companies, and the monthly fee varies among insurers. You will share in the costs of your prescription drugs according to the specific plan in which you’re enrolled. Those costs can include a deductible, a flat copayment amount, or a percentage of the full drug cost (called “coinsurance”).

Penalties can arise if benficiaries do not address Medicare Part D.

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What is the Most Important Problem that

Senior Citizens Face today?


 
 Deteriorating health, malnutrition, lack of shelter, fear, depression, senility, isolation, boredom, non-productivity, and financial incapacity are the most common problems that senior citizens all over the world face today. These problems can be grouped into two categories that relate to the physical and mental health and the financial capacity of the senior citizen.
 
 1. Physical and Mental Health

 
Stability of physical and mental health is a key concern that senior citizens have to contend with as they go through their twilight years. The human body is a system that wears out with long and repetitive use; and quite easily, with neglect and abuse. Aging is a life-cycle stage where the human capacity to think, act, relate, and learn starts to falter and deteriorate. Aging breeds illnesses such as loss of memory, immobility, organ failure and poor vision. These are critical dysfunctions that could sideline a senior citizen to a lonely and miserable life.
 
2. Financial Capacity
 
Possessing sustainable financial capacity before, during, and after the inception of a senior status is both a basic problem and an elusive dream for most people. This financial dilemma is common among senior citizens who are usually relegated to an abject position of economic inactivity. Lack or absence of financial capacity creates a stressful life and invites the entry of problems other than physical and mental health issues. For instance, domestic problems in an extended family system can aggravate the problem of a financially-destitute senior citizen. Should any of the children be wallowing in a similar state of poverty, the senior citizen becomes physically and mentally loaded up with intense and continuing pressure out of being totally helpless to come to the financial rescue of a grieving son or daughter.

While it may not be the panacea to aging-related problems, the value of money cannot be overstated in the post-retirement period. A financially-handicapped senior citizen, afflicted with some degenerative or serious illness, is practically on the road to an early death. A financially secure senior citizen with the same illness, however, may have a longer life to live because because money can give quick and convenient access to life-giving remedies. Even with state-of-mind dysfunctions like severe depression, boredom, nervous breakdown, and self-pity, financial capacity can buy options to rejuvenate and refresh a financially-capable senior citizen, through travels, elderly recreation, social renewal, and continuing education. A poor senior citizen in the same state of mental degradation cannot afford to do the same; and more so, be back into the mainstream of society.

As can be discerned from the preceding discussions, the severity and importance of both health and financial problems is a function of the milestones the senior citizen had set up preparatory to facing the challenge of post-retirement. These milestones are: 1) Quality: What lifestyle had been lived in the past 2) Quantity: what endowments and financial fortune had been built 3) Relationships: what community of people the senior citizen had moved about and is attached with.

What is then the most important problem that senior citizens face today? Is it health (physical and mental) or financial capacity?

From a practical and realistic standpoint, I consider the inseparable tandem of health and financial capacity as the most important problem that senior citizens have to prepare and plan for. I use the phrase "prepare and plan for" because health and financial capacity becomes a problem only if the senior citizen had, in the past, been unmindful or neglectful of its future importance.

A healthful life is like a running well-oiled machine, with its vital parts continuously maintained so that it can perform normally, or at peak productivity, beyond its anticipated useful life. The onset of sudden serious health problems can be substantially mitigated, if not totally avoided. This holds true if the senior citizen, at the time of his or her prime, had led a clean, discreet, active, family-based, helpful, and interconnected life, a discipline that builds premium on fitness, integrity, peace, humility, fulfillment, and friendship.

Financial hardships can be avoided if the senior citizen, during his or her period of economic activity and utility, had deliberately exercised foresight, focus, continuous learning, perseverance, and simplicity, a discipline that consistently upholds the importance of modest needs, savings, productivity, competence, and delivering superior value to people and organizations. The idea here is to build a sustainable wealth of lifetime resources to address the financial requirements of the person across the twilight zone.

On my mother's die, my grandma died at the age of 95-years-old while my grandpa passed away at 92. With no known serious illness at the time of their death, we were all of the opinion that they died by reason of old age. How did they manage to both live a long life?

With regard to having a healthful life, both my grandma and my grandpa were vegetarians. They religiously observed a full eight-hour night sleep and a two-hour afternoon nap everyday. They were both active. With my grandma coming from a political family, she was all over the community interacting with people during her free time. My grandpa, who was a full-blooded Christian, was quite busy each day evangelizing on the Bible with different kinds of people. As we had initially lived at my grandparents' home, I could clearly recall that there was no day that they did not have visitors, at least two to three batches of people with different stories and problems to tell and request advice for. In short, they were always interconnected with people. It was a home full of excitement, sharing, and guidance, an abode that I think was the spring of long life for my grandparents.

As to how my grandparents sustained a fairly comfortable life, even if both of them were economically inactive, was to me a story of disciplined survival worth emulating and modeling upon. The household just lived on the small pension of my grandpa plus some assistance from an uncle who was gainfully employed. But my grandma, who closely tracked and managed the finances, had the regimen and capacity to prioritize and stretch the budget in a manner that, on a monthly basis, the basic needs were sufficiently addressed and some residual money were tightly saved.

Though my grandma was a stickler of kindness and generosity to people, I never witnessed any moment that they were in the run for some emergency money. Neither had they borrowed anything from any relatives or friends. To my estimation, they had a retirement fun chest that remained intact until the hour of their death. and how did this happen? I think it was a providential blessing. Incremental assistance money, though in reasonably small amounts, regularly flowed in from people who had been helped by my grandparents, not financially, but on the resolution of their domestic and career problems.

Whenever I go on a recollection mode about my childhood and adolescent days, I am elated for being a grandson to my grandparents. Such recollection always reinforces in me the non-erasable thought that the abstract endowments of wisdom, compassion, kindness, humility, and transparency not only build a reputation of respectability and a life of longevity; but also, over time, they give finite financial returns that can bridge people to a fulfilling post-retirement life as a senior citizen.

with all the exciting, fun-filled, and encouraging lessons from my grandparents, I have no apprehension facing the life of a senior citizen. It is all how you live and love your life in the service of your family, of the people around you, and humanity in general.