Do You Need Help Understanding Your Medicare Coverage?

Do You Need Help Understanding Your Medicare Coverage?

Medicare coverage is a critical source of health insurance coverage for more than 40 million people. However, understanding the various components of Medicare advantage plans can be a source of concern for many people who fear that checking the wrong box may make them not eligible for important medical coverage.

With a little guidance, you can be sure that you are making good choices in your Medicare coverage.

What is Medicare?

Medicare is the federal government-backed health insurance program that helps people over 65 and disabled Americans pay for medical care. The program consists of two main parts. One for hospitals and one for medical insurance, Part A and Part B and two additional parts which provide prescription drugs and flexibility, Part C & Part D.

What does part A cover?

Medicare Part A coverage, also called Hospital Insurance (HI), helps pay 90 days of hospital care for “sick period” after a minimum annual deduction is met. Covered medical care during a hospitalization includes things like:

  • Meals
  • Proof
  • Semi private room
  • Supplies
  • Operating room, Intensive care unit, Coronary unit
  • Medications provided by the hospital.
  • Blood transfusions after the first three pints.

Part A also covers home health care when necessary. This includes services such as physiotherapy, occupational therapy and speech therapy. Attention in specialized nursing centers and necessary medical equipment, such as walkers and wheelchairs. Part A coverage is generally available without copayment.

What is Medicare Part B?

Part B of Medicare coverage, also called Supplemental Health Insurance (SMI), helps insure outpatient services such as ambulance services, visit to office, and many preventive services. If you enroll in Part A plan, you automatically enroll in Part B except you decide not to participate in Part B insurance. Part B subscribers spend a monthly fee equivalent, on average, to a quarter of those costs Part B services

What is Medicare Part C?

Part C, or the Medicare Advantage Plan, combines parts A and B and gives the applicant the opportunity to choose from an approved list of health professionals. In many cases, part C is a lower cost alternative to the original Medicare plan.

What is part D coverage?

Part D is an independent prescription drug coverage plan. Within Plan D, there are several different drug plans to choose from. Although all required medications are covered, most subscribers will pay a premium for this service.

If you are approaching eligibility for Medicare and are confused about your options, contact your local Health Insurance Counseling and Advocacy Program (HICAP) to obtain impartial health advisors.