Medicare 101

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Medicare 101 老年醫療保險初學指南




Medicare is the federal government program that provides health care coverage if you are 65+, under 65 and receiving Social Security Disability Insurance for a certain amount of time, or under 65 and with End-Stage Renal Disease.

耆英保險是可以提供健康護理保障範圍(醫療保險)的聯邦政府計畫,如果您是65歲以上或是65歲以下並獲得社會保障殘疾保險(SSDI)一段時間65歲一下並伴有終末期腎臟疾病(ESRD).


Once you have become Medicare-eligible and enroll, you can choose to get your Medicare benefits from Original Medicare, or from a Medicare Advantage Plan, a type of private insurance offered by companies that contract with Medicare (the federal government).

獲得耆英保險資格並註冊後,您可以選擇從Original Medicare或Medicare Advantage Plan獲得耆英保險相關福利,Medicare Advantage Plan是與Medicare簽約的公司所提供的一種私人保險


What is the original Medicare?

什麼是 Original Medicare?


Original Medicare consists of Part A and Part B. If you have Original Medicare, the government pays directly for the health care services you receive. Additionally, enrolling in Original Medicare means:

Original Medicare 包含A部分和B部分. 如果您有Original Medicare,那麼政府將直接為您獲得的醫療服務付款。 此外, 加入Original Medicare代表:


  • You will receive a red, white, and blue Medicare card to show to your providers

  • 您將收到一張紅色,白色和藍色的耆英醫療保險卡,向您的醫生或診所出示

  • Most doctors in the country take your insurance

  • 大多數醫生都接受您的保險

  • Medicare limits how much you can be charged if you visit participating and non-participating providers, but it does not limit how much you can be charged if you visit providers who opt-out of Medicare

  • 耆英保險限制了您使用participating和non-participating providers的費用,但並沒有限制如果您選擇退出耆英保險的提供者的費用

  • You can see a specialist without prior authorization

  • 您無需事先授權即可與專家見面

  • You are responsible for Original Medicare cost-sharing, which may include premiums, deductibles, and coinsurances

  • 您需要分攤Original Medicare的費用,其中可能包括保費,免賠額和共同保險

  • You are eligible to enroll in a Medigap policy, which can help reduce your out-of-pocket costs

  • 您有資格參加Medigap政策,這可以幫助您減少自付費用


Part A

A部分


In general, Part A covers:

一般來說, A部分涵蓋:

  • Inpatient care in a hospital

  • 醫院的住院治療

  • Skilled nursing facility care

  • 熟練的護理設施護理

  • Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)

  • 療養院護理(非監護或長期護理的熟練護理機構中的住院護理)

  • Hospice care

  • 臨終關懷

  • Home health care

  • 家庭保健



Part B

B部分


Part B covers 2 types of services Medically necessary services:

B部分涵蓋2種類型的醫療必需服務:


  • Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.

  • 診斷您的醫療狀況或治療您的服務和用品。

  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

  • 預防服務:預防可能的疾病(例如流感)的醫療保健或在最有可能取得最佳治療效果的早期階段進行檢測與干預。


Source 文章來源: https://www.medicare.gov/

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