Medicare Discussion Post
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1. U.S. citizens or permanent legal residents greater than five continuous years are eligible for Medicare. This benefit is most often associated with the elderly, but Medicare benefits are available for younger population with disabilities after you receive Social Security Disability Insurance for 24 months.“Medicare is not just health insurance for older Americans. Seven million Americans under age 65 have Medicare coverage because of severe and permanent disability. But once deemed “disabled” by the Social Security Administration, people under 65 must wait 24 months for Medicare to kick in.” (Medicare and Disability, 2007) In addition, people with End Stage Renal Disease, which is permanent kidney failure that requires dialysis or transplant, are eligible for Medicare. The reason for this is that most people with disabilities will have lower incomes and require more health care. With lower income it would be more difficult to afford the healthcare they would need to treat their disabilities. “They are more likely to have cognitive impairments, report themselves in poor health, and are more likely to have limitations in one or more activities of daily living.” (Center for Medicare Advocacy, 2019)
Medicare beneficiaries can be treated in a foreign hospital for inpatient hospital, doctor, ambulance services, or dialysis, but there are a few stipulations to be covered by Medicare. First, is that the medical emergency occurred the U.S and the foreign hospital is closer than the nearest U.S. hospital that can treat you. Another cases would be if you were traveling through Canada without unreasonable delay between Alaska and another state when a medical emergency occurs, you would be covered under Medicare. There is one more scenario, if you are on a cruise ships, as long as the cruise ship is within 6 hours of a U.S. port, the Medicare beneficiary will be covered.
2. Generally, Medicare is available for people age and older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant) (US Dept. of Human Services). A resident has to live in the United States for years before applying for Medicare. They must be living in the United States the years before applying for Medicare. If you have a qualifying disability and are under age 65, you are eligible for Medicare. Two qualifying disabilities are End Stage Renal Disease or Lou Gehrig’s. Part A will cover hospital costs and skilled nursing facility costs. Part B will cover physician’s offices and outpatient care. Part D covers prescription plans. Being under 65 with Medicare, you can get Part A benefits and not have to pay premiums. Although, everyone must pay for Part B. These individuals are able to enroll in Medicare because these are considered terminal illnesses.
If you have original Medicare, you have coverage anywhere in the U.S. and its territories (Medicare Interactive, 2019). This includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Most doctors and hospitals take Original Medicare (Medicare Interactive, 2019). Medicare typically does not cover medical care you receive when traveling outside the United States and it’s territories. You can get a Medigap policy that will cover travel abroad. In emergency situations, an individual can be treated in Canada and on cruise ships.
