Medicare: An Easy Overview

WebMD Medical Reference

If you're new to Medicare, you may find the program confusing. Getting a grip on the different deadlines, parts, co-pays, deductibles, and other odds and ends may seem next to impossible. WebMD is here to help you understand the basics.

Just remember: Medicare is the right of every U.S. citizen over 65, regardless of income or employment. Some people under 65 who have a disability, Lou Gehrig's disease, or advanced kidney failure are also entitled to it. Medicare is yours, so you should know how to use it.

Medicare is broken into several parts, covering different types of care.

• • Medicare Part A helps pay for hospital stays, hospice, some home health care, and some nursing care.
• • Medicare Part B helps pay for doctor's visits, lab tests, and other medical care.
• • Medicare Advantage plans are replacements for Part A and B that work like private insurance. (These used to be called Medicare + Choice Plans.)
• • Medicare Part D (Prescription Drug Plans) provides some financial help to pay for your medicines.
• • Medigap is optional additional coverage sold by private insurance companies that pays for some things that Part A and Part B don't.
• • Medicaid is not part of Medicare, but a separate government program that helps people with low incomes pay for medical care.

Does Medicare Have to Be So Confusing?

Medicare was started more than 40 years ago. Over the decades, the government has tweaked the program, changing details and names, and adding new types of coverage. Because it's been tinkered with so much, the end result can be hard to understand.

But don't get overwhelmed. It may take a little work, but you can learn how to get the most out of Medicare. For all its faults, Medicare is a program that helps keep millions of Americans healthy.

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Reviewed by Brunilda Nazario, MD, December 2006.

SOURCES: Vicki Gottlich, senior policy attorney, Center for Medicare Advocacy, Inc., Washington. Henry J. Kaiser Foundation web site, "Medicare Advantage." Medicare web site, Medicare and You 2007; "Choices: Overview"; Nancy Wood, Media Relations Manager, AARP, Washington.