Medicare is divided into parts. Each part signifies which type of care is paid for.
Medicare Part A
- Hospital stays
- Hospice care
- Time in a skilled nursing facility
Medicare Part A is generally regarded as hospital insurance even though it covers more than just a stay in the hospital. It also does not require any sort of premium by the person who is insured if they meet the requirements. The rule of thumb for whether a premium should be paid is if someone has worked for at least 10 years or 40 quarters and paid Medicare taxes throughout.
It is important to note that Medicare Part A does not completely cover the cost of a hospital bill. An insured person will have to pay some part of the cost. In terms of specifics, Medicare does cover up to 60 days in the hospital and 20 days in a skilled nursing facility completely.
The maximum number of days for a hospital stay is 90 and 100 for a skilled nursing facility. After the initial 60 or 20 days are used up, you pay for a part of the stay. Lifetime reserve days kick in after that. They help cover days spent in the hospital after 90 days consecutively.
Medicare Part B
- Doctor visits
- Blood tests
- Outpatient care
- Home care
Medicare Part B covers the routine medical things a person might need for their health. Doctor visits, screenings, and x-rays are just some of the common things that this part of Medicare provides coverage for. It is considered traditional medical insurance and requires a premium to be paid each month. It also covers durable medical equipment (DME) like wheelchairs, walkers, and hospital beds. A doctor must approve the equipment order before Medicare will sign off.
Other services covered under Medicare include therapies such as physical therapy, occupational therapy, and speech therapy. Certain types of drugs qualify under this part of Medicare too. These are usually specialty drugs to treat conditions like cancer, gastrointestinal conditions or others that require a physician to administer them. Chiropractic care and ambulance services also fall under Medicare Part B.
Medicare Part C
Medicare advantage insurance plans are usually considered Medicare C. They operate like traditional insurance plans. People who opt for advantage plans still have Medicare A, B, and D and they must still pay premiums for Part B. But out of pocket costs for prescription drugs and other medical costs may be cheaper under an advantage plan.
As with regular private insurance carriers, there are different plans to choose from. Each one fits a person based on their own needs, such as whether the ability to see any doctor is essential. We can help you understand the differences and find the right plan.
Medicare Part D
Medicare Part D is prescription drug coverage. It is optional. It helps defray the costs of medications for recipients of Medicare up to a certain amount each year. After this amount is exceeded, the insured must pay out of pocket up to a certain limit until catastrophic coverage kicks in, requirements are met to go back under the limit, or another insurance kicks in.
Medicare Supplements (Medigap)
In addition to the parts of Medicare broken down above, there's also Medicare Supplement plans. There are 10 plans available, labeled A-N. The most common plan is Medicare Part F. This plan covers all the different benefits available, it also has a high deductible version.