If you are getting older or are caring for your elderly loved one, it is important for you to learn about Medicare. The professionals at Elder Care Direction can help you to understand Medicare and what it might pay for. Here is what you need to know about the program.
What is Medicare?
Medicare is a government health insurance program that provides coverage to disabled people, elderly people, and people who are suffering from an end-stage renal disease. Medicare has four parts that are called Medicare Parts A, B, C, and D.
Medicare Part A
Medicare Part A covers inpatient stays in hospitals and skilled nursing facilities. However, it does not cover long-term care facilities. It also covers hospice care and some types of in-home care if your loved one meets certain requirements. Medicare Part A doesn’t have a monthly premium for most people because they paid taxes for Medicare while they worked for a certain number of years. People can purchase Part A if they didn’t work long enough to earn sufficient credits and are disabled or are 65 or older. If your loved one buys Part A, he or she will also be required to enroll in Medicare Part B and pay premiums for it, too.
Medicare Part A pays for the following services if they are medically necessary:
- Stays in hospitals, excluding private rooms
- Inpatient mental health care up to a maximum 190 days during a lifetime
- Skilled nursing facility care for up to 100 days per benefit period
- Limited home health services
- Hospice care
- Medicare Part B
Medicare Part B is a type of government medical insurance that covers medically necessary medical services. These include outpatient care, doctors’ services, diagnostic services, and other medical services that are not covered by Part A. You do not have to join Medicare Part B, but most people choose to do so because of the relatively low premiums.
If you receive Tricare, you must get Medicare Part B to keep it. However, if you are on active duty or are the dependent child or spouse of an active duty service member, you will not have to get Part B immediately. Medicare Part B has a monthly premium that will depend on your annual income. You will also have an annual Part B deductible to pay before Part B will begin paying for its share of your medical costs. If you do not get Part B when you are initially eligible, your premiums will increase by 10 percent for every 12-month period that you could have had it but didn’t get it. People have to pay coinsurance for services that they receive. Part B pays 80 percent of the costs, leaving people to pay the remaining 20 percent.
Medicare Part C
Medicare Part C lets beneficiaries purchase private health insurance policies that are subsidized by the government. This coverage replaces what you would have received under Parts A and B.
Medicare Part D
Medicare Part D is prescription drug coverage for people who have Medicare. This helps to reduce your prescription costs and to protect you against higher future costs. You will have the option to join a Medicare drug plan if you choose. If you do, you will be charged a monthly premium.
Medigap policy
Medigap policies are private insurance policies that can be purchased to supplement Part A and Part B coverage. Medigap pays for the copayments and deductibles that you would otherwise have to pay. You have to have Medicare Part A and B to purchase a Medigap policy.
You are able to purchase a Medigap policy during the six months that starts on the first of the month of when you turn 65. If you don’t purchase it then, you may face higher premiums in the future.
Contact Elder Care Direction
Medicare is a popular program for elderly and disabled people. To learn more about Medicare and how it might benefit you or your loved one, contact Elder Care direction by filling out our contact form or calling us.
