Medicare Coverage Guidelines

Medicare is a subsidized health insurance program run by the federal government to provide affordable health care to seniors and people with certain medical conditions that are not covered by private insurance companies. Medicare coverage is divided into four parts: Part A covers hospital insurance; Part B, doctors' services; Part D, prescription drug subsidies; and Medicare Advantage offers supplemental plans run by private companies but approved by Medicare.

Eligibility

• Americans over 65 or with end stage renal disease (kidney failure) and a handful of other disabling conditions can enroll in Medicare. You most likely are eligible for Medicare if you have been receiving disability payments from the Social Security Administration for at least 24 months. You can enroll online.

Part A

• Medicare offers a variety of different services and plans. Part A is hospital insurance and covers hospital stays, services and procedures at hospitals and in-patient treatment. Medicare's web portal states that most people do not pay premiums for Part A, but in 2010, those who do paid $250 to $460 per month. The rates change annually. If you are still working at age 65 and have an employer-provided health plan, the Social Security Administration recommends that you sign up for Part A, which covers more hospital services at better rates than most private plans, but not Part B, which is very similar to most private plans.

Part B

• Part B is medical insurance that covers doctor's visits, outpatient care, durable medical equipment (such as wheelchairs, walkers and oxygen tanks) and associated costs such as laboratory tests, as well as preventable care and related tests. The premium for Part B was $96 for most people in 2010; however, following passage of health care reform law in March 2010, premiums went up to $110 for individuals making more than $85,000 and couples making more than $170,000.

Part D and Medicare Advantage

• Part D defrays the cost of prescription drugs and is run by private companies that have been approved by Medicare. Part D sometimes is combined with Medicare Advantage plans, which are private plans approved by Medicare that cater to specific needs -- for example, people in nursing homes or with high prescription drug costs. Part D and Medicare Advantage costs vary widely, depending on a person's needs and income.