What is Medicare?

Medicare is a federal government health insurance program enacted in 1965 for people age 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). Often referred to as “Original Medicare”, this program covers many health care services and supplies; however, there are some costs (gaps) that it does not cover.

Medicare is divided into two parts. The different parts of Medicare help cover specific services: Part A, which is for hospital and skilled nursing facility expenses and Part B, which is for medical expenses such as doctor, outpatient facility and home health care charges. Each part of Medicare has its own set of deductibles, co-payments and pre-approved charges.

Does Medicare cover all medical expenses?

Medicare covers most, but not all expenses. There are certain co-payments, coinsurance, and deductibles that you are responsible for. When the cost of a medical procedure is greater than Medicare’s “approved” charge, you are responsible to pay the difference. This is why there are private insurance options, such as Medicare Supplement Insurance to help pay for the expenses that Medicare does not cover. Medicare will pay its share of their “approved” amounts, and then your Supplemental policy will pay its share of “approved” charges that Medicare does not pay.

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