While Medicare is broken down in to four different parts; A, B, C, and D, there are a number of plans for someone to choose from under Medicare. Medicare is health insurance provided by the government, not private insurance companies. Someone becomes eligible for Medicare if they are 65 years of age or older, under 65 and receiving disability payments, or if they have permanent kidney damage requiring dialysis. The most basic of plans is the Original Medicare Plan. This plan includes type A, hospital coverage, and type B, basic medical coverage.  An individual will pay a deductible each year, which must be met before the government starts to pay, and co-payments at the time of service. Part B is optional, and if used, the member is subject to a monthly premium as well.

Medicare part C is actually a plan in itself. These plans are called Medicare Advantage Plans. They work like HMO’s and PPO’s.  Such plans include parts A and B and cover extra services outside of the Original Plan, such as dental care, vision care and gym or health club memberships. With an Advantage plan, any medically-necessary service must be covered. Most Advantage Plans also include part D, which is prescription drug coverage. Members of part C are also insured against catastrophic costs over $5,000 and usually have a portion, or all, of their parts B and D premiums refunded.

Part D of Medicare is prescription drug coverage. Someone can have solely a prescription drug plan, of which there are thousands to choose from, based on the drugs needed, a member’s location, and preference of generic or brand-name drugs. A Prescription Drug Plan Finder can be used to find the best plan for an individual.

The rarest form of Medicare is the Medigap plan. It covers some of the holes not filled by the Original Plan, such as providing emergency care outside of the U.S., and in some cases, helping with prescription drug costs. These plans are set up through private insurance companies, which then share the costs with the government.

Part B of Medicare covers many of the areas that are not covered by Medicare part A. Individuals are qualified to receive part B if they are receiving Social Security disability payments for 24 months, Social Security retirement payments, or if they are entitled to Medicare part A . When your Medicare card is sent, you have the option to deny Medicare B coverage. However, you can enroll in part B during the open enrollment period for no charge or at any other time, if eligible, and by paying a fee. Part B covers physicians’ services, outpatient visits, x-rays , medical equipment and similar services.

1. Physicians’ services;

2. Home Health Care;

3. Services and supplies, including drugs and biologicals which cannot be self-administered, furnished incidental to physicians’ services;

4. Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests;

5. X-ray therapy, radium therapy and radioactive isotope therapy;

6. Surgical dressings, and splints, casts and other devices used for fractures and dislocations;

7. Durable medical equipment;

8. Prosthetic devices;

9. Braces, trusses, artificial limbs and eyes;

10. Ambulance services;

11. Some outpatient and ambulatory surgical services;

12. Some outpatient hospital services;

13. Some physical therapy services;

14. Some occupational therapy;

15. Some outpatient speech therapy;

16. Comprehensive outpatient rehabilitation facility services;

17. Rural health clinic services;

18. Institutional and home dialysis services, supplies and equipment;

19. Ambulatory surgical center services;

20. Antigens and blood clotting factors;

21. Qualified psychologist services;

22. Therapeutic shoes for patients with severe diabetic foot disease;

23. Influenza, Pneumococcal, and Hepatitis B vaccine;

24. Some mammography screening;

25. Some pap smear screening, breast exams, and pelvic exams;

26. Some other preventive services including colorectal cancer screening, Diabetes training tests, bone mass measurements, and prostate cancer screening.

Medicare B does not cover the following services:

1. Services which are not reasonable or necessary;

2. Custodial care;

3. Personal comfort items and services;

4. Care which does not meaningfully contribute to the treatment of illness, injury, or a malformed body member;

5. Prescription drugs which do not require administration by a physician;

6. Routine physical checkups;

7. Eyeglasses or contact lenses in most cases;

8. Eye examinations for the purpose of prescribing, fitting, or changing eyeglasses or contact lenses;

9. Hearing aids and examinations for hearing aids;

10. Immunizations except for influenza, pneumococcal and hepatitis B vaccine;

11. Cosmetic surgery;

12. Most dental services ;

13. Routine foot care

Medicare B covers 80% of medical fees, based on what Medicare considers a "reasonable charge" for a certain service. If there is a discrepancy between a doctor’s fee and the "reasonable charge" the patient is responsible for the difference. However, the provider is not legally allowed to charge more than 115% of the "reasonable charge". The biggest complaint about Medicare B is the out-of-pocket expenses. The monthly premium for part B is based on income and is between $96.40 and $238.40. There is also a $135 deductible, meaning that the patient must pay $135 for services before Medicare will start to cover its 80%.

Medicare.gov is the official U.S. government site for people with Medicare. It is considered a “consumer beneficiary” website that provides information on Medicare, Medicare health plans, Medicare prescription drug plans, eligibility, providers in your area, and basically any and all information one could need when a member of Medicare. Users are allowed to sign up as members of the website and save and document the information that they come across and find useful. Every form one could need is available for download as are pages and pages of doctor, and other provider, information according to a specified location and area of specialization.

Medicare.gov is an invaluable website for Medicare and Medicaid members. The most impressive feature of the site is its multiple search tools. One can search to compare and contrast doctors, facilities, and services they are eligible for.  The search criteria can be very detailed and specific and the user will still be provided with a wealth of information. Perhaps the most helpful tool on the site is the long-term care planning tool. This tool allows users to search options for the present and the immediate, and not-so immediate, future. From there they can make a contigency plan if something were to happen where they were not able to take care of themselves anymore.

Our older generation, the “greatest generation” according to Tom Brokaw, are not as technologically savvy as the youngest generations. Navigating a simple website can be surprisingly difficult, as the technology is still foreign to them. A retired person, who was out of the workforce before computers were commonplace, might normally have a hard time taking advantage of this site. Medicare.gov provides clear, logical links, offers tutorials on search tools, such as the prescription drug plan finder, and makes most forms available for download as well as submission over the internet. The site makes available excellent information, which is not only easy to find, but also, easy to understand. Any and all members of Medicare and Medicaid have a remarkable tool in Medicare.gov. Necessary, important information is only a click away.

With the economy the way it is, we all could use a little help finding affordable health care. Here are 10 ways to help you with finding affordable health care.

1. COBRA. First, it is best to start with the Consolidated Omnibus Budget Reconciliation Act (COBRA). If you’re unemployed you may be eligible to continue your last employers’ health insurance through COBRA. This also applies to young adults going off to college, you also may be able to continue on your parents health insurance coverage through COBRA. This is a very good option for people who may have lost their job and are still undergoing medical treatments.

2. Workers’ Compensation. If you are being treated for any work related injury, your employer must offer you treatment under their Workers’ Compensation program.

3. Medicaid. Don’t automatically think that since you have a job you won’t qualify for Medicaid. Medicaid will pay health care expenses for low-income families and individuals. Each state sets the eligibility requirements so qualifying for the program is dependent on the state.

4. Medicare. Medicare is provided by the government and administered by the Social Security Administration. If you are sixty-five years old or older you would qualify for Medicare. You may also qualify if you are getting Social Security disability benefits.

5. State High Risk Health Insurance Pool. If you are turned down by individual health insurance companies because of pre-existing conditions, your state may have a high risk health insurance pool you can obtain health insurance from.

6. Individual and Family Health Insurance: This is where you just go to an insurance company and buy individual or family health insurance the same way you would by home or auto insurance. Getting a high deductible “emergency” policy is a better way to maintain a low cost health insurance plan and keeping a Health Savings Account for smaller health issues will probably save you money in the long run.

7. Short Term Health Insurance Coverage: This is a great affordable health insurance option for someone in-between jobs or who knows they will be starting a job soon.

8. Group Insurance from Organization Memberships. Some people are members of specific organizations that offer health insurance coverage.  Although these organizations often do not help pay the health insurance premiums like an employer would, the rates would be lower because of the group discount.

9. Group Health Expenses Sharing Plan. This is not insurance but works similar to it. This is when a group of people pool their money together and pay each others’ health expenses… they pretty much become their own insurance company. The contributions are pooled together and usually invested in order to accrue interest on the pooled funds. It works well when there are a lot of people who contribute and everyone is only using the money for major medical expenses. There are religious groups that use this model successfully.

10. Health Insurance Discount Cards. Again, this is also not an insurance plan but can be a good source for getting low cost health services. You pay a small monthly fee for a membership card and when you go to the doctor or hospital you will get a discounted rate on your services

Medicare part D is an important part of the Medicare Prescription Drug, Improvement, and Modernization Act enacted in 2003. However, it did not begin to take effect until January 1, 2006. The plan is administered by The Centers for Medicare and Medicaid Services (CMS) . Medicare part D provides insurance coverage on prescription drugs, but is not part of the original Medicare program. Private insurance carriers actually administer the Prescription Drug Plan (PDP) and they are reimbursed by CMS.

There are two private plans under which someone can receive prescription drug coverage; through a Prescription Drug Plan that covers drugs only or through a Medicare Advantage (MA) plan. A MA plan includes both medical services, parts A and B, and prescription drugs. There are about 40 to 50 Medicare part D plans, on average, in each state or CMS region. As of the start of 2008 there are over 1,800 part D plans available. These different plans allow the covered to choose the drugs to be covered, the types of drugs, and therefore the copay they will be responsible for. Average monthly premiums for the standard plans are around $30, but can range from $8-$135. Those enrolled can use a Prescription Drug Plan Finder to figure out the best plan for them based on price, drugs and location. These plans are the best for individuals who regularly take prescription drugs.

The MMA also established a standard benefit plan available to all part D participants. This plan includes a $295 deductible. Once the deductible has been reached Medicare will pay for 75% of prescription drug costs up to a $2,405 initial coverage limit. After this amount is reached, the patient is in what is called "The Donut Hole " or coverage gap. They must now pay the full price of their prescription drugs until total yearly spending has reached $4,350. This means that they will be responsible for $1,945 of prescription coverage. Once they have passed the $4,350 limit, catastrophic coverage is reached, which provides generic medications for $2.25 and brand-name for $5.65, or 5% of total cost, whichever is greater. The standard plan is more suited for infrequent prescription drug users or those who are not taking prescription drugs currently, as a contingency plan.