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what is medicare wiki


Welcome to the unofficial Medicare (USA) Wiki

Medicare is a United States federal government program implemented in 1965 to provide health coverage to Americans aged 65 and older and people under 65 with certain disabilities.

The Medicare wiki will review Medicare Parts A-D, Medicare Advantage Plans, Medigap, and all things Medicare.

Original Medicare

Medicare as established in 1965 consisted of Medicare Part A and Medicare Part B. which remain the foundation of Medicare coverage for many people. Part A helps cover hospital costs, while Part B normally pays 80 percent of the cost of covered medical expenses.

Of the approximately 50 million Americans on Medicare in 2013, about 83 percent are 65 and over. With the United States Centers for Medicare and Medicaid Services projecting large annual increases in the number of Americans 65 and over for the foreseeable future, the Medicare program is expected to continue growing significantly in terms of enrollment and expenditures.

Medicare Part C (Medicare Advantage)

Medicare Part C was established in 1997 and, since 2003, has been known as Medicare Advantage .

Medicare Advantage plans are optional Medicare plans offered by Medicare-approved private companies. Part C plans, which replace Medicare Part A and Part B coverage with similar coverage, are primarily network-based, and typically offer additional or supplemental coverage. Most Medicare Advantage plans cover prescription drugs.

Currently, over 14 million Americans are enrolled in Medicare Advantage plans including Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, and Private Fee-for-Service (PFFS) plans.

Medicare Part D

Medicare Part D,  which provides prescription drug coverage, was established in 2003 and took effect in 2006. Part D plans are optional, stand-alone drug plans that help many Medicare beneficiaries reduce prescription drug costs.

Medicare Supplement Plans

Over 10 million Medicare beneficiaries supplement their coverage under Original Medicare by purchasing Medicare Supplement insurance. Noted for filling the gaps in Original Medicare, Medicare supplement insurance is also known as Medigap. Ten different Medicare supplement plans (Plans A, B, C, D, F, G, K, L, M, and N) are available, offering varying degrees of coverage. People enrolled in Medicare supplement plans may not be enrolled in Medicare Advantage plans at the same time, although they are eligible to purchase Medicare Part D drug plans.

Medicare Open Enrollment Period (OEP) / Annual Election Period (AEP)

From October 15th to December 7th, 2013, OEP / AEP gives Medicare Benificiaries the opportunity to make changed to his or her Medicare plan for 2014. During this time, benificiaries may:

  • Enroll in a Medicare Advantage plan
  • Cancel Medicare Advantage and switch back to Original Medicare
  • Purchase or change Prescription Drug coverage plans
  • Purchase or change Medicare Supplement plans  if they are on Original Medicare
(Medicare Advantage benificiaries can not be sold a Medicare Supplement plan) 

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