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A Quick Overview Of Medicare For Residents Of Georgia


BARNESVILLE Georgia Hospital
Upson Regional Medical Center
801 W Gordon St
Thomaston, GA 30286
Plus code: VMP7+87 Thomaston, Georgia




Medicare is a federal health insurance program run by the Centers for Medicare & Medicaid Services. There are a few minor variances across states, but the vast majority of Medicare is the same throughout the United States, so the coverage Georgia people receive will be comparable to Medicare coverage around the country.


Two Categories Of Individuals Are Eligible For Medicare.

  • Individuals 65 and older who are citizens of the United States or who have lived in the country legally for at least five years straight.
  • Individuals younger than 65 with certain qualifying illnesses or disabilities.



  • Medicare Part A

    Part A, generally known as Medicare hospital insurance, covers inpatient hospital treatment, skilled nursing facility care, hospice care, and certain types of qualifying home health care. Nursing services, a semi-private room, prescription medications, and other medically essential services and equipment are normally reimbursed if part of a beneficiary's inpatient treatment.

    Hospice care is also covered if a beneficiary is diagnosed with terminal illness and has six months or less to live. Included are doctor/nursing services, hospice aide services, physical/occupational therapy, prescription medicines, and caregiver respite care.

    Part A does not provide benefits for long-term nursing homes or care facilities. Coverage is limited to institutions where support with personal care, such as eating and bathing, is not the only aid provided to a beneficiary.


    Eligibility

    Those who paid Medicare taxes while employed for at least ten years are automatically enrolled in free Part A coverage when they turn 65. (40 quarters). You might be eligible for premium-free Part A benefits if your spouse is. If they are, then you might be as well. If you or your spouse are currently receiving or are eligible for Railroad Retirement benefits, you may also be eligible for free benefits. Even if the applicant's spouse passed away or got divorced, this benefit is still available.
    Even if you don't have a job, you can still enroll in Part A, but you'll have to pay a monthly premium.

    In order to be eligible for Medicare Part A benefits if you are under 65, you must:

    Meet the requirements for the Social Security disability program. You may be eligible if you have end-stage renal disease (ESRD) or permanent kidney failure that necessitates ongoing dialysis or a transplant, receive disability benefits due to Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig's disease), are the child or widow(er) of a worker who worked in a government job for a sufficient amount of time to have paid Medicare taxes, are 50 years of age or older, After receiving one of these disability benefits for 24 cumulative months, you are automatically enrolled in Parts A and B. These months don't have to be one after the other.


    Enrollment

    In Georgia,if you obtain Social Security or Railroad Retirement Board benefits, you'll usually get Part A and Part B coverage when you turn 65. Under 65 disabled people get Part A and Part B after 24 months of Social Security or Railroad Retirement Board disability benefits.

    In all circumstances, you'll get a Welcome to Medicare package including your card and Medicare information. You can enroll in Medicare during your Initial Enrollment Period if you don't meet these conditions (IEP). Your IEP spans the 7 months before and after you turn 65.

    If you qualify, you can enroll in Part A and Part B after your IEP finishes. You can also enroll during Medicare's General Enrollment Period (January 1 to March 31), but you may risk higher rates and delayed coverage.


    Costs

    If you qualify, Part A coverage is free, but you may have to pay deductibles for hospital stays.If you don't qualify for free Part A coverage, you can still sign up and pay a premium if you meet the following conditions:

    You are at least 65 years old.
    You are enrolled in or in the process of enrolling in Medicare Part B coverage.
    You meet citizenship and residency requirements. The cost of your premium will depend on how long you have worked and how close you are to getting the minimum of 40 Social Security credits.

    Most of the time, if you enroll in and pay for Medicare Part A, you must also enroll in and pay a separate premium for Medicare Part B.


    Upcoming Article: Understanding Medicare Part B, C, and D.




    Speaking with a true Medicare health insurance specialist will be the best way to sum up all the information you acquired, and turn it into a smart health plan choice.  When it comes to choosing the right health care plan, knowledge and expertise are an irreplaceable necessity.

    A good insurance broker can help you with all aspects of the health insurance plan purchasing process.  Because their expert assistance is normally free, getting assistance from a licensed Medicare insurance professional is a smart, sensible step in any insurance purchasing decision.

    Good to know:  Check medical bills for errors.  Medical billing errors happen a lot more than you would think.  Oddly, these errors almost always benefit the hospital or medical facility.  Make sure that you receive an itemized bill in the mail.  These bills delineate in detail the charges you incurred for each of your medical procedures.  In this regard, they contain greater utility than the explanation of benefits (EOB) you generally receive in the mail.  If your medical bill omits key information regarding charges incurred, contact your healthcare facility and ask for an itemized bill.  Once you have received this bill, review it carefully.  Did you actually receive every procedure listed?  If so, is the cost what you were promised beforehand?  Additionally, look out for billing errors when it comes to pharmaceuticals.  Often, healthcare billers make the mistake of charging individuals for name-brand drugs instead of generic drugs.


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    Choosing a health insurance plan is not something to take "lightly".  We are happy to assist.

    We understand how difficult it can be to choose the best plan for you and your family's needs.  Plan benefits, physician networks, deductibles, Rx coverage, and other components of a health insurance plan, should all be carefully considered.

    Our licensed Medicare insurance professionals are happy to assist in sorting through all of the details in order to acquire a quality, affordable health insurance plan that meets the needs of you and your family.  Our services are free.  call now.    770-872-2018

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