Medicare is a federal health insurance option—so how does it stack up to its private health insurance competition?
Medicare as a Federal Insurance Program
As you may already know, Medicare is a federal insurance program offered through the Affordable Care Act. As such, it is more strictly regulated than privatized insurance. It is, then, fairly straightforward.
Once you have reached age 65, have End-Stage Renal Disease (ESRD), or have earned 10 months of Social Security Disability benefits, you are eligible for Original Medicare.
Benefits for Original Medicare (Parts A and B) are also the same across the board. For Part A, you will receive emergency hospital care up to 60 days and nursing facility/home coverage up to 20 days. For Part B, you will receive general benefits for insured care or services deemed “medically necessary” by your doctor.
Medicare and Private Insurance Together
However, Parts A and B are not your only Medicare insurance options. Medicare offers a variety of alternative and additional health plans that are somewhat of a compliment to your federalized Medicare coverage.
These plans include Medicare Advantage (Part C), Medicare Supplements (Medigap), and Medicare Part D. No matter what, these plans will have all of the benefits and coverage of Original Medicare, with additional coverage at different costs relative to the private insurer.
The Benefits of Private Insurance Over Medicare
All of that being said, there are still benefits to private insurance that Medicare can’t offer. Limited eligibility is one of the greatest dividing factors. If you aren’t eligible for Medicare, you will, of course, have to opt for a private option.
In terms of cost, private insurance varies greatly. While the options can be overwhelming, you have the option to compare and find the best possible deal. In other words, you have options. With Original Medicare, premiums and deductibles are fixed no matter age, location, etc.
The Benefits of Medicare Over Private Insurance
However, Medicare is generally considered the superior option to private insurance, for a variety of reasons. For one, prices are fixed—for select individuals, having a variety of price options is a benefit. But for most people, this saves the headache of outrageous premiums and deductibles based on personal factors.
And, if you still want extra private insurance, there are federally-regulated private options. Advantage, supplements, and Part D are all private but provide extra coverage alongside your Original Medicare plan.
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