The Williamson group, LLC Medicare 2018 The Williamson group, LLC

What is Medicare Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). The different parts of Medicare help cover specific services:

There are several parts to Medicare Medicare A – covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Medicare B - covers certain doctors' services, outpatient care, medical supplies, and preventive services. Medicare C - A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits Medicare D - Part D adds prescription drug coverage to Original Medicare

Medicare Costs Most individuals don’t have to pay a monthly premium for Part A because they earned 40 credits while working. This is achieved by paying payroll taxes for at least 10 years. If you don’t earn enough work credits to qualify for premium-free Part A, then you could pay up to $411 a month for coverage in 2016. This amount goes up each year. There are also deductibles and copayments associated with Part A.

What charges Medicare part A covers

Part A Hospital and Skilled Nursing Facilities Most individuals don’t have to pay a monthly premium for Part A because they earned 40 credits while working. This is achieved by paying payroll taxes for at least 10 years. If you don’t earn enough work credits to qualify for premium-free Part A, then you could pay up to $411 a month for coverage in 2016. This amount goes up each year. There are also deductibles and copayments associated with Part A. Acute care hospitals, inpatient rehabilitation facilities, critical access hospitals, long-term care hospitals, mental health care, and inpatient care that falls under a qualifying clinical research study are all covered by Medicare Part A. Things that are not covered under Medicare Part A include private-duty nursing, a private room that is not medically necessary, a telephone and television that warrant extra expenses, and personal grooming items. Medicare Part A covers Skilled Nursing Facility (SNF) care as well. While in the SNF, the following are covered: semi-private rooms, skilled nursing care, meals, physical and occupational therapy, medical social services provided through a social worker or other social service provider, speech and language pathology services, medical supplies and equipment used in the facility, medications, dietary counseling, and ambulatory services when it is a life or death situation. In order for Medicare Part A to cover a Skilled Nursing Facility, the following must happen: First, you must have Part A and you must have days left in your benefit period. There must have been an immediately prior inpatient hospital stay that was approved by a physician. Your physician must specify that SNF care is essential. Your SNF eligibility can be impacted if there is a break in your SNF care. If you leave the SNF facility for 30 days or more, you may need to have a 3-day qualifying inpatient stay in order for Medicare Part A to cover SNF again. If there is a break in SNF care that lasts for 60 consecutive days, your current benefit period ends and a new benefit period begins. Medicare Part A also covers services in a Long-Term Care Hospital (LTCH). If the following conditions are met, you will not have to pay a second deductible for a stay in an LTCH: An acute hospital transfers you directly to the LTCH You’re admitted to the LTCH within 60 days of being discharged from an acute hospital. However, if you are admitted to a Long-Term Care Hospital after 60 days, you pay the same deductible and coinsurance that you would have paid if admitted to an acute care hospital.

What charges Medicare part B covers

Medicare Preventive benefits Medicare covers most preventive care, free of charge. In some cases, Medicare will only cover these tests if you have certain risk factors.

Medicare Part C Advantage Plans What Charges Are Covered Under Medicare Advantage Plans Examples are: Aetna, Humana, and Cigna which offer plans such as HMO, PPO and Private Fee for Service (PFFS) Sample Footer Text 4/7/2019 9