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As a service from us to you: we have gathered thousands of health information articles. All the articles are authoritatively sourced, constantly updated, bi-lingual, and searchable. Please come back any time you want straightforward, correct answers to health information questions.

Medicare

Medicare is the U.S. government's health insurance program for people age 65 or older. Some people under age 65 can qualify for Medicare, too. They include those with disabilities, permanent kidney failure, or amyotrophic lateral sclerosis.

Medicare helps with the cost of health care. It does not cover all medical expenses or the cost of most long-term care. The program has four parts:

  • Part A is hospital insurance
  • Part B helps pay for medical services that Part A doesn't cover
  • Part C is called Medicare Advantage. If you have Parts A and B, you can choose this option to receive all of your health care through a provider organization, like an HMO.
  • Part D is prescription drug coverage. It helps pay for some medicines.

Choosing a Doctor or Health Care Service

We all want high-quality health care, but it's hard to know how to choose. There are many things to consider, including:

  • What your insurance covers
  • Whether a health care provider or service is accredited
  • The location of a service
  • Hours that the service is available
  • Whether you like a health care provider's personality

On this page you'll find information to help you choose a health care provider or service.

Health Insurance

Health insurance helps protect you from high medical care costs. It is a contract between you and your insurance company. You buy a plan or policy, and the company agrees to pay part of your expenses when you need medical care.

Many people in the United States get a health insurance policy through their employers. In most cases, the employer helps pay for that insurance. Insurance through employers is often with a managed care plan. These plans contract with health care providers and medical facilities to provide care for members at reduced costs. You can also purchase health insurance on your own.

People who meet certain requirements can qualify for government health insurance, such as Medicare and Medicaid. The Affordable Care Act expands health insurance coverage for many people in the U.S.

Managed Care

Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan's network. How much of your care the plan will pay for depends on the network's rules.

Plans that restrict your choices usually cost you less. If you want a flexible plan, it will probably cost more. There are three types of managed care plans:

  • Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
  • Preferred Provider Organizations (PPO) usually pay more if you get care within the network. They still pay part of the cost if you go outside the network.
  • Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care.

Medicaid

Medicaid is government health insurance that helps many low-income people in the United States to pay their medical bills. The Federal government sets up general guidelines for the program, but each state has its own rules. Your state might require you to pay a part of the cost for some medical services.

You have to meet certain requirements to get Medicaid help. These might involve:

  • Your age
  • Whether you are pregnant, blind, or have a disability
  • Your income and resources
  • Whether or not you are a U.S. citizen or, if not, what your immigration status is

Centers for Medicare and Medicaid Services

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