Medicare is a health insurance program offered by the federal government. This program is administered by the Department of Health and Human Services. Coverage is offered to individuals age 65 and over. You must qualify for Part A and Part B coverage in order to take part in this health insurance program. You may also qualify if you have certain disabilities, End-Stage Renal Disease (ESRD), or Lou Gehrig’s Disease (ALS).
The two most common forms of coverage are Medicare Part A and Part B. This article will explain to you what each part covers as well as what it does not cover. If you still have questions after reading, don’t worry. Our team of licensed agents are on call at your convenience to answer your questions and help you enroll.
Need medicare in Boca Raton? Seeking Medicare in Port St. Lucie or Greenacres? Call us at (561) 420-0280. We help our clients in Palm Beach County and throughout the Treasure Coast with all their Medicare needs.
What Medicare Part A Covers
Part A is hospital insurance. You are eligible for premium-free Part A if you are age 65 or older and you or your spouse paid Medicare taxes while working for a period of at least 10 years. You will have deductibles and it will not cover 100% of the costs of care. It offers Medicare coverage for many types of facility care as well as lab tests. Read below to see what types of facility care is offered.
Inpatient Hospital Care
There are certain conditions required for accepted coverage. You need a doctor’s order for inpatient treatment prior to admission. The hospital you are admitted to also must accept Medicare. If you are admitted without prior orders from your doctor, you can still use Part A if the hospital ‘s review committee approves your stay.
Skilled Nursing Facility
Medicare Part A covers short-term care under certain conditions. Your doctor must determine you need daily skilled nursing care or therapy. You also need to have a qualifying inpatient stay and have days available in your benefit period.
Nursing Home
Assistance with bathing, dressing, using the bathroom, getting dressed and help with eating is considered Custodial Care and is not covered under Part A. It must be medically necessary for you to receive skilled nursing care in order to qualify.
Hospice Care
You qualify for coverage if your doctor certifies you have less than 6 months to live or if you are in need of Palliative care, also known as comfort care.
Home Health Care
Home health services that are covered by Part A may include medical social services, occupational therapy, and physical therapy to name a few.
What Medicare Part B Covers
Part B covers medical expenses other than hospitalization. This includes preventive as well as medically necessary services. Some of the services covered by Part B are:
- Ambulance Services
- Clinical Research
- Durable Medical Equipment
- Outpatient Prescription Drugs
- Mental Health Services (Inpatient/Outpatient and Partial Hospitalization
Let Absolute Best Insurance Help You Get the Coverage You Need!
Don’t go through the process alone, let one of our agents help you navigate through the application process at no additional charge. We will review your current plan and tell you what it covers and what you need. Call Absolute Best Insurance in Greenacres, Port St. Lucie and Boca Raton at (561) 420-0280 or click here.