There are multiple parts associated with Medicare health insurance. Understanding
these differences in your options, premiums and coverage must be considered before
making your final choice. Your first choice in the Medicare program is known as part
a insurance. Part a insurance is available to everyone who paid into the Medicare
insurance program and having a total of 40 quarters. When one turns 65 the individual
and or their spouse becomes eligible. If you have not met your criteria you may be
able to purchase part a coverage for a premium. Understanding what Part A coverage
encompasses is a must before making your final decision…
Part A Medicare?
Medicare provides Part A insurance for hospital and other inpatient nursing care
facilities. Skilled nursing facilities (nursing homes), critical care hospitals,
hospitals and rehabilitation Hospital are usually covered under this policy. Long
term care is not covered Under Part A. In some cases you may be eligible for hospice
or home healthcare if you meet specified requirements...
Part A Medicare exclude?
Knowing what is not covered is almost as important as knowing what is covered. Be
sure you understand Medicare does not cover everything and it does not cover totally
many services and or needed supplies. The amount of coverage you receive depends
greatly on which supplement policy you may choose. The Part a only covers necessary
Companies offering private insurance may act as your agent and be responsible for
paying and processing your Part A Medicare insurance claim. They will deal directly
with the federal government for you. There are many companies offering this service
so it is wise to compare has many as possible. To evaluate the best price and the
best coverage be sure to compare apples to apples, coverage to coverage and price
Semi private rooms are covered during your stay as a inpatient in the hospital. Normally
meals, nursing care, supplies and other services are included. Mental health hospitals
might also be covered if you meet certain criteria. Be sure to read your individual
policy and understand what is and is not covered.
Skilled nursing facility (Nursing Homes) coverage
To Qualify for these facilities the patient must be diagnosed by a medical professional
(Dr.) The Doctor Must ascertain if the person is not able to take care of their self
due to a medical or physical impairment is involved. Nursing homes like hospitals
limit the coverage to a semi private room, including meals and rehabilitation services
including nursing skills. In the case of rehabilitation hospitals there is limited
maximum coverage for 100 days in one benefit period. Under Part A coverage the initial
20 days are fully covered with the 80 day remainder requiring a copayment by the
patient. Long term care remains a uncovered option as well as non-professional daily
assistance or companion care.
Professional home healthcare service?
Limited Home Healthcare services are normally included when diagnosed as a medical
necessity. Care limited to part-time services include licensed nursing care, physical
therapy, occupational therapy home health care aides language and speech therapy
and social services. Certain medical equipment can be included (hospital beds, wheelchair,
walkers and oxygen if necessary) necessary medical supplies will also be covered
under your Part A Medicare coverage.
Hospice Care Services?
A terminally ill patient with less than six months to live his eligible for hospice
care. Medication for pain relief and drugs prescribed to control unwanted symptoms
is included In Part A coverage. Other services including grief counseling and medical
support are also covered. Your hospice caregiver must be Medicare approved. They
can provide the services in your home or in a skilled nursing facility (nursing homes).
As always be sure to check and make sure your Medicare policy covers all hospice
services. Many of these may not be covered under certain plans.
The choice of your Medicare insurance policy must be totally understood by you before
making any decision. Be sure to compare all the premiums and all the coverage that
is offered. Compare multiple insurance providers, their fees compared to there coverage.
If you do not understand asked the Medicare representative any question you are unsure
of. Be sure you totally understand what they are saying before you sign up for anything.
There is no such thing as a dumb question when you are making this choice.
Additional Medicare insurance supplement s and Medigap policy options will be explained
further on other pages on the website.
In general, Part A covers:
Skilled nursing facility care
Nursing home care (as long as custodial care isn't the only care you need)