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Medicare VS Private Health Insurance


Medicare (also known as "Medicare Part A" and "Original Medicare") is the federal healthcare program for adults ages 65 and older, or under age 65 with certain disabilities.

Private health insurance is a type of coverage that helps pay for medical expenses.

What is Medicare?

Medicare is a federal health insurance program for people 65 and older, younger people with disabilities, and people with End-Stage Renal Disease (ESRD). It’s administered by the Centers for Medicare & Medicaid Services (CMS), which is part of the U.S. Department of Health & Human Services (HHS).

Medicare provides health insurance coverage to those who meet certain eligibility requirements. If you have Medicare benefits and have low income or limited assets, you may qualify for premium-free Part D prescription drug coverage even if you don't have any other health insurance coverage through a private plan or employer-sponsored retiree plan.

Medicare Parts Explained

Medicare is a federal health insurance program that helps millions of senior citizens and people with disabilities stay healthy and safe. Medicare provides four parts to help you pay for your medical care:

  • Part A is free, and covers in-hospital hospitalization, skilled nursing facility care, and some home healthcare services.

  • Part B is optional and covers doctor visits, tests, and other services outside the hospital. You must have Part A to get Part B.

  • Part D is optional, but requires an active prescription drug plan through an employer or union group health plan (or directly from Medicare). This part covers prescription drugs that are covered by the plan sponsor's formulary (list of approved drugs). You can sign up for Medicare Drug Plan during the enrollment period each year between October 15th - December 7th if you are age 65+ or disabled; otherwise it will be available from November 1st – December 31st.

Who is Medicare for?

Medicare is a federally funded health insurance program designed specifically for people over the age of 65.

Medicare coverage is also available to individuals on disability, and those suffering from end-stage renal disease (severe kidney failure) or amyotrophic lateral sclerosis (ALS). Learn more here:

Medicare Cost

If you happen to be one of the lucky ones who are eligible for Medicare Part A and Part B, then you can rest assured that your health insurance is free. After all, Medicare is a government-funded program designed specifically to ensure that elderly people have access to affordable health care.

By paying into the Medicare tax throughout their working years, individuals have helped fund this necessary service—and now that they are retired or disabled, they can reap its benefits. What's more: although there are some restrictions on eligibility for certain benefits outlined below (like deductibles), most people will qualify for either type of coverage under Medicare. In addition to being able to purchase additional supplemental insurance policies through private companies like Blue Cross Blue Shield or Aetna if needed as well as supplemental Medigap plans from private insurers

What is private health insurance?

Private health insurance is an insurance policy that covers medical expenses. Private health insurance does not include the Medicare scheme, which is a government scheme. Private health insurers are regulated by APRA, the Australian Prudential Regulation Authority.

Private health insurance costs

The cost of private health insurance depends on a number of factors. Firstly, it will depend on the type of cover you purchase and can vary from one health fund to another.

Private health insurance is not free – you need to pay a premium to your insurance company each month or year depending on your level of coverage. The premium is based on your age and postcode, as well as the level of coverage chosen (for example basic hospital care or comprehensive hospital and extras).

Private health insurance and Medicare

Medicare is a scheme that provides health insurance to Australian citizens, permanent residents, and some temporary residents. It's also known as Medibank. Medicare is funded by the government.

There are two kinds of public health insurance schemes in Australia: Medicare and WorkCover.

But What Is Health Insurance?

Health insurance is a type of insurance that helps you pay for medical expenses that aren't covered by your health plan.

It helps you get the care you need when you're sick or have an injury.

Health insurance can include:

  • Prescription drug coverage, so you don't have to worry about paying for medications out of your own pocket.

  • Out-of-pocket maximums, which limit how much money you'll spend on healthcare during a year or over the course of your lifetime—a benefit many private plans offer to help keep costs down.

  • Preventive care coverage, such as screenings and checkups for certain conditions (like diabetes) before they get worse and more expensive to treat in the long run if neglected early on.


When you compare Medicare and private health insurance, it’s important to understand what each plan offers. Medicare is more comprehensive than most private health plans but also more expensive. As with any financial decision, it’s important to weigh the pros and cons of each option before deciding which works best for your needs.

About Preferred Senior Benefits in Meridian, Idaho

Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Original Medicare coverage is broken into two parts - Part A and Part B - and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays, while Part B covers outpatient or medical care. Together, Part A and B cover about 80% of the typical healthcare costs seniors face. This leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818 2523. We cannot wait to help you learn about your options

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