Understanding Your Medicare Coverage

Understanding Your Medicare Coverage

Understanding Your Medicare Coverage

Comments Off on Understanding Your Medicare Coverage

Although Medicare Advantage has increased in popularity, Original Medicare is still the preferred way to get Medicare benefits for most seniors. As of 2017, 67% of Medicare beneficiaries were covered by Part A and Part B. If you’re weighing your Medicare options, here’s what you should know about Original Medicare.

What is Original Medicare?

The Medicare program was created in 1965 to provide health benefits for seniors. It is managed by the federal government; benefits, premiums, and deductibles are set at the federal level and are essentially the same for everyone covered by the program.

Original Medicare has two parts, Part A, also known as hospital insurance, and Part B, which covers outpatient medical services like doctor visits and diagnostic tests.

Original Medicare is a fee-for-service program, which means you pay for healthcare services as you get them. Unlike network-based Medicare Advantage plans, you can use Original Medicare at any doctor or hospital that accepts Medicare. If you purchase supplemental coverage like Medigap, you can use that at any Medicare provider as well.

What benefits are covered by Original Medicare?

Part A pays for hospitals stays that are deemed medically necessary as well as care in a skilled nursing facility. If you need home health care in the two weeks immediately after a hospital stay, Part A covers that too. Finally, it covers hospice care.

Part B covers most preventive care and most medical services to diagnose and treat illnesses and conditions, including mental illness.

Original Medicare does not cover dental care, routine vision or hearing services, cosmetic procedures, or care outside the U.S. It also doesn’t cover prescription drugs you take at home, except in very rare circumstances, such as oral cancer medications and immunosuppressants after an organ transplant.

How much does Original Medicare cost?

Most people don’t pay a Part A premium; the Part B premium is set by the federal government each year and is usually deducted from your Social Security or Railroad Retirement Benefits check each month.

If you have income above a certain level, you may have to pay a premium adjustment each month directly to Medicare.

There is an annual deductible with both Part A and Part B. After you meet your deductible, Part A pays 100% of covered charges for up to 90 inpatient days for a single illness or injury each year; after that, you pay a daily copayment.

Medicare pays 80% of most covered services under Part B after you meet your annual deductible. There is no copayment or coinsurance for some preventive services.

What is Medicare assignment?

When a doctor or hospital accepts assignment, it means it will accept Medicare reimbursement amounts as payment in full for covered services. Providers who accept assignment bill Medicare first before sending you a bill for the balance.

You can still get care from providers that don’t accept assignment, but you will pay more out of pocket. You can be billed up to 15% more than the Medicare-approved amount for health care services, and the provider may not file a Medicare claim on your behalf.

Donald Phillips

Related Posts

Beauty Is A Relative Term; Beauty Supplements Are Not!

Comments Off on Beauty Is A Relative Term; Beauty Supplements Are Not!

The Role of Sutures in Gynaecology: A Review

Comments Off on The Role of Sutures in Gynaecology: A Review

Employ a Residential Company For Additional Customizable Waste Collection Options

Comments Off on Employ a Residential Company For Additional Customizable Waste Collection Options

Cannabis Oil for Cancer: What You Need to Know

Comments Off on Cannabis Oil for Cancer: What You Need to Know

Learning to Cope With Stress and Avoid Relapse

Comments Off on Learning to Cope With Stress and Avoid Relapse

Orthopedic Doctors in Brooklyn & How the Can Help You!

Comments Off on Orthopedic Doctors in Brooklyn & How the Can Help You!

6 tips for skin to fight winter season

Comments Off on 6 tips for skin to fight winter season

Do You Need to Know More About Your Neighbor?

Comments Off on Do You Need to Know More About Your Neighbor?

5 Tips for Planning Healthy Meals for Your Toddler

Comments Off on 5 Tips for Planning Healthy Meals for Your Toddler

How Much Can You Earn as a Personal Trainer?

Comments Off on How Much Can You Earn as a Personal Trainer?

Are Marijuana, Alcohol, and Cigarettes Actually Gateway Drugs?

Comments Off on Are Marijuana, Alcohol, and Cigarettes Actually Gateway Drugs?

Body Fat Loss Pills and Supplements

Comments Off on Body Fat Loss Pills and Supplements

Create Account



Log In Your Account