Seniors work hard throughout their lives hoping to spend their retirement in comfort. Their loved ones want to ensure that everything possible gets done to provide proper care. It’s important to understand all of the things that Medicare Part A, B, C and D cover, and what they don’t. Look at the potential services that might be required for a senior. Is it clear that Medicare will provide compensation for needed care? No one wants to see their loved one cut off from much needed medical services due to a lack of proper coverage.
Understanding Medicare Part A
Medicare Part A covers all hospital services. This includes stays in these types of facilities:
- Inpatient Hospital – This includes care provided in acute care, critical access, inpatient rehabilitation, and long-term care hospitals. Seniors must pay a deductible along with coinsurance costs that vary depending on the length of the stay.
- Skilled Nursing Facility – This covers any that must be administered by a doctor or nurse in a hospital setting. The type of care provided includes intravenous injections, physical and occupational therapy, skilled nursing care, and medical social services. Certain requirements must be met before Medicare will approve and pay for services in a skilled nursing facility. Costs rise as the length of the stay increases. After 100 days, the patient bears the burden of paying for everything.
- Long-term Care Hospital – These hospitals treat patients with serious conditions with an expectation of recovery and an eventual return home. Patients pay the same deductible as they would for an inpatient hospital. Those moving from an inpatient hospital to long-term care aren’t required to pay an additional deductible.
Understanding Medicare Part B
Part B covers any medically necessary or preventative services required by the patient. Medically necessary means any care needed to aid the treatment of a patient’s illness or injury. Preventative services are any care provided to prevent the onset of any new illness or to address the patient’s overall well-being.
Covered services include:
- Mental health treatment
- Flu shots
- Durable medical equipment (DME)
- Ambulance services.
Patients must verify that any care or equipment provided falls under the scope of what Medicare will cover. Otherwise, they will be responsible for all costs.
Understanding Medicare Advantage Plans
Commonly referred to as Medicare C, these Medicare plans are issued by private insurance carriers. They cover the same services as traditional Medicare but have different rules depending on the carrier. It’s up to the patient to keep up with any changes the insurance company might make to these plans.
Understanding Drug Coverage
Also known as Medicare D, this covers any outpatient drugs needed by the patient. Patients choose a drug plan from private insurance carriers. With drug coverage, there’s no direct coverage provided by the government.
Getting The Right Guidance
It often difficult for seniors and their loved ones to keep up with what Medicare will cover. A critical misreading of one provision bears the risk of Medicare denying payment for care. This leads to a stressful financial burden on the senior and often their family. Knowing the differences in coverage makes it easier:
- Medicare Part A covers all hospital services
- Part B covers any preventative services needed by the patient
- Medicare Advantage, or Part C, are issued by private insurance carriers
- Part D covers prescription drugs
The Long Term Living Association (LTLA) works to help seniors and their families understand the complexities of Medicare coverage. We meet where it’s convenient at any time between 8 am and 8 pm. We help determine which supplemental Medicare insurance plans would help fill coverage gaps. This is done by walking patients and families through various plan options from Medicare supplemental insurance companies, clarifying what benefits they provide.
There’s no need to undertake this journey alone. Reach out to LTLA by visiting our website and scheduling a 15-minute phone call. Everyone should be able to enjoy their retirement without worry. Let us help with that.
