Medicare is a government program that provides health insurance coverage for senior citizens age 65 years and older, the disabled of any age, and to anyone suffering from end-stage renal disease.

Medicare is divided into four parts, which are known as Medicare Part-A, B, C, and D.

≤ What is Medicare Part-A?

Part-A is hospital insurance, which helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (but does not cover custodial or long-term care). Medicare Part-A also helps cover hospice care and some home health care, but you must meet certain conditions to get these benefits.

Cost of Medicare Part-A: Most people don’t have to pay a monthly premium for Part-A, because they or a spouse paid Medicare taxes while working for a certain number of calendar quarters during their lifetime.

If you don’t get premium-free Part-A you may be able to buy it if you or your spouse aren’t entitled to Social Security because you didn’t work or didn’t pay enough Medicare taxes while you worked and are age 65 or older, or you are disabled but no longer get free Part-A because you returned to work.

In most cases, if you buy Part-A coverage, you must also enroll in Part-B and pay the Part-B premium too. If you have limited income and resources, your state may help you pay for Part-A and/or Part-B.

≤ What services does Medicare Part-A cover?

Medicare Part-A pays for medically necessary services including:

Hospital Stays – Semi-private room, meals, general nursing, drugs, and other hospital services and supplies. This includes inpatient care you get in critical access hospitals and mental health care. This doesn’t include private-duty nursing or a television or telephone in your room. It also doesn’t include a private room, unless medically necessary. Inpatient mental health care in a psychiatric hospital is limited to 190 days in a lifetime.

Skilled Nursing Facility Care – Semi-private room, meals, skilled nursing and rehabilitative services, and other services and supplies (only after a three-day inpatient hospital stay for a related illness or injury) for up to 100 days in a benefit period.

Note: Medicare does not cover long-term care. See our Guide to Long Term Care for complete information about your long term care options and financial aid programs that can help pay for long term care.

Home Health Services – Limited to reasonable and necessary part-time or intermittent skilled nursing care and home health aide services, and physical therapy, occupational therapy, and speech-language pathology ordered by your doctor and provided by a Medicare-certified home health agency. Also includes medical social services, other services, durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers), and medical supplies for use at home.

Hospice care – For people with a terminal illness (less than six months to live). Includes drugs for symptom control and pain relief, medical and support services from a Medicare-approved hospice, and other services not otherwise covered by Medicare (like grief counseling). Hospice care is usually given in your home (may include a nursing facility if this is your home). However, Medicare covers some short-term hospital and inpatient respite care (care given to a hospice patient so that the usual caregiver can rest).

≤ What is medicare Part-B?

Part-B is medical insurance, which covers most common medical services, when they are medically necessary, including doctors’ services, outpatient care, laboratory and diagnostic services, and other medical services that Part-A doesn’t cover.

You are not required to join Medicare Part-B if you do not want to, but the vast majority of Medicare beneficiaries choose to enroll, because the premium is relatively low for the amount of health insurance benefits that it provides.

≤ Medicare Part-B and TRICARE Coverage – If you have TRICARE, you must have Medicare Part-B to keep this coverage. However, if you are an active duty service member, or the spouse or dependent child of an active duty service member, you may not have to get Medicare Part-B right away. You can get Part-B during Special Enrollment period, and in most cases you won’t have to pay a late enrollment penalty.

≤ Cost of Medicare Part B – You have to pay a premium for Part-B every month, which varies depending on your yearly income. The standard monthly premium in 2012 is $99.90 per month. The Part-B premium is higher for individuals with incomes above $85,000 per year, and for couples with incomes above $170,000 per year.

You also pay a Part-B deductible every year before Medicare starts to pay for its share of your medical expenses. You may be able to get help from your state to pay this premium and deductible.