Medicare is a national program that is administered by the United States Federal Government. It includes 4 parts – Part A, Part B, Part C, and Part D. Medicare Coverage is available to people 65 or older. People younger than age 65 with certain disabilities entitled to Social Security disability or Railroad Retirement Board benefits for 24 months and people with certain disabilities. People diagnosed with end-stage renal disease (ESRD).
Covers inpatient hospital, inpatient skilled nursing facility, hospice and some home health service.
This medical insurance covers physician services, outpatient care, durable medical equipment, home health services and several preventative services.
This is also known as Medicare Advantage (MA) and includes Medicare-approved private insurance companies that provide all Part A and Part B services and may provide prescription drug coverage and other supplemental benefits.
Is the Medicare Prescription Drug Benefit – Medicare approved private insurance companies that provide outpatient prescription drug coverage.
This type of plan can be added to the original Medicare. Original Medicare (Parts A & B) pays for a lot of costs for health care services, and supplies, however it does not cover them all. Medicare Supplemental Insurance is sold by private companies and can help pay some of the remaining health care costs that are not covered for services and supplies. Things like copayments, coinsurance, and deductibles are things that supplemental can step in and meet to be the gap. We can discuss your specific needs and recommend specific plans that will appropriately work within the gap for you.
Medicare Advantage is hailed as an alternative to original Medicare, providing “all in one” plans. These plans include Part A, Part B and Part D, in most cases. These plans may have a lower out of pocket cost than Original Medicare. In most cases, you’ll need to use doctors that are within the plan’s network. Most of these plans offer extra benefits that Original Medicare doesn’t offer, such as vision, hearing, dental and more.
Medicare Part B covers medically necessary diagnostic treatment services you get as an outpatient. With this type of plan you’d need to ensure that you are receiving outpatient services from a Medicare-participating hospital. Specific services that could be covered may include: Emergency or Observation services, overnight stays, same-day surgeries, laboratory tests billed by the hospital, mental health care in a partial hospitalization program (as long as the doctor certifies that inpatient would be required without it), X-rays and other radiology services, medical supplies, preventative screening services and certain drugs that you wouldn’t typical give yourself. Part B does not generally include prescription drugs and over the counter drugs that you might receive in an outpatient setting.
Medicare Part A will pay bills related to hospital care, skilled nursing facility or nursing home care, hospice care and home health services. It covers expenses such as semi-private room at a skilled nursing facility; inpatient care, medical supplies needed during your care, and drugs administered during a hospital stay; physical and occupational therapy in your home if you are homebound; and doctor’s services, Medicare and grief and loss counseling for terminally ill patients.
This plan does not cover everything. Providers are required to ask patients to sign a notice in advance of receiving treatment when a service they are offering may not be covered. You can choose whether to accept or decline the service. It is a good idea to find out before using the service if Medicare Part A service will cover part or none of the cost.