Originally conceived as a big step toward ensuring health care coverage and financial stability for our nation’s older population, Medicare is a federal insurance program that provides guaranteed health insurance for people age 65 and older and for younger people who qualify because of a disability. More commonly known as original Medicare or traditional Medicare, the program refers to the first two parts of Medicare, Part A and Part B, included in a bill that President Lyndon B. Johnson signed into law in 1965.
- Part A helps pay for inpatient stays in hospitals and skilled nursing facilities, some home care and end-of-life hospice care.
- Part B covers doctors’ services, diagnostic screenings, lab tests, outpatient care, preventive services, plus some medical equipment and transportation.
With a Medicare Advantage plan, your coverage comes from a private insurer even though you sign up for Part A and B through the federal government. You still must pay the Part B premium, and these plans must provide at least as much coverage as original Medicare, but they can have different out-of-pocket costs.
Advantage plans may offer additional coverage not part of original Medicare, such as dental, hearing, prescriptions and vision. Because most Medicare Advantage plans have a provider network, doctors you have already who are not part of the network could cost you more or not be covered at all. You may need permission from the plan’s officials, called prior authorization, to see a specialist.
Medicaid is a health insurance program available for qualified individuals meeting certain requirements. Qualified individuals include low-income adults, children, pregnant women, elderly adults, and people with disabilities. The program is administered by states but funded by both the federal government and the states themselves.