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Making The Right Decisions

Medicare Part A

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...

... Nursing Home Medicare Part A
Choosing your insurance option...

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 medical services.

 

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 to price.

 

Covered Hospital.

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:

Hospital care

Skilled nursing facility care

Nursing home care (as long as custodial care isn't the only care you need)

Hospice

Home health services

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Part A, Part B, Part C, & Part D, in Texas