An introduction to Medicare plans in Chicago

As one grows older, it becomes evident that health insurance is critical. To meet these needs, the government of the United States provides Medicare. Medicare is health insurance tailored to the health needs of the elderly.

The original Medicare plan is split into two parts — Part A and Part B. These plans are available for beneficiaries across all states, including Illinois. So essentially, Medicare plans in Chicago are no different from Medicare plans in other regions. However, it can be confusing to navigate the complexities of a health insurance plan, especially a government-mandated one.

What is Medicare?

• Medicare is a federal government sanctioned and funded health program catering to three categories of citizens — those above the age of 65, younger people with disabilities, and patients suffering from End Stage Renal Disease (ESRD).
• ESRD patients require dialysis or a kidney transplant or transfer.
• These criteria will help you know if you, your family, or your friends are eligible for Medicare plans in Chicago.
• However, this information is about the revamped Medicare. Its previous version worked slightly differently.

How did the original Medicare work?

• The government managed all the health coverage in this version of Medicare. Each service had a cost attached to it to ensure that the system worked efficiently.
• The coverage you received and the amount you had to pay for Medicare plans in Chicago depended on a range of factors, some were under your control while others, not so much.
• Some of these factors were the type of healthcare you opt for, whether your health insurance worked with Medicare, how often and to what extent you used the services, and whether these services were covered by Medicare, etc. There were provisions for Medigap policies too.
• Understandably, the system needed some changes. The new Medicare plans were simpler for all citizens to understand.

What should you consider while choosing your Medicare coverage?
When you are considering Medicare coverage for yourself, you need to account for seven factors that will help you get the best Medicare plan in Chicago.

• Costs: Consider your yearly costs on health care including hospital stays and visits to a doctor. Also, take into account the upper limit to how much you can pay, your deductibles, premiums and other costs, and which coverage plans affect these costs.
• Coverage: The plan you choose must cover all the services and costs you need the most.
• Other kinds of coverage: If you have coverage for your healthcare or prescription-based needs, consider how it can work with a Medicare policy. Check if you can negotiate for better benefits or changes.
• Prescription medication: You need to think about the need for a joint Medicare plan for prescription medications along with your normal coverage unless you already have coverage for your prescription medications. You must consider the amount that you’re paying for your current plan and check if you’re eligible for any free programs. You can change your policy or update it if you are getting better benefits.
• Choice of doctor and hospital: If you’re opting for a new plan, check if your doctor and hospital accept your new coverage. Also, verify if any referrals are needed and if you need to change your hospital or doctor. However, everyone can’t make or afford these changes, so thoroughly check the terms and conditions beforehand.
• Quality of care: One should consider if they are satisfied with their current health care plan or if it needs specific changes. Comparing plans and providers is essential, and one needs to do the same with Medicare.
• Travel coverage: While this factor is not a priority, the coverage you pick should ideally be valid outside your state and if possible, even outside the country.

What does Part A cover?

• Part A covers the following factors — hospital care, hospice, nursing home care, skilled nursing facility care, and home health services.
• Medicare coverage in Chicago is directly affected by the following factors — the Federal and State laws of Illinois, coverage decisions that Medicare makes, and local decisions made by companies that process claims for Medicare.

What does Part B cover?
Part B covers the following aspects — ambulance services, clinical research, durable medical equipment (DME), mental health, outpatient prescription drugs (limited), and a second opinion before surgery. However, the services it covers are split into two parts —

• Medically necessary: These include services needed to diagnose and treat any medical condition that fits the coverage.
• Prevention services: These include health care services needed to prevent or detect certain illnesses in the early stages. Preventive health care can help to avoid further damage.