What Does Medicare Cover for Seniors?

Last Updated: 22.04.19

 

Many old people choose to use walkers for older adults because they help them improve their mobility, and they also provide balance. These types of devices are extremely useful especially for seniors who live in nursing homes. They are more common in these places because they offer seniors all the necessary independence.

When it comes to healthcare, it is very important to know what your health insurance covers and what it doesn’t. Medicare has many different plans which can make it a little confusing for some people. If you were wondering if Medicare is offered by the federal government, the answer is yes, and it is for people that are 65 years old, or older.

The Medicare plan contains four parts: A, B, C, and D and each of them covers various aspects of healthcare. Those people mentioned above can enroll in one or more parts, but the most common are parts A and B. The reason is simple – they cover most services. A monthly premium needs to be paid which varies based on income.

Part A

Medicare Part A is also called hospital insurance and is the one that covers the cost if you are admitted to a hospital or skilled nursing facility. It also covers walkers, wheelchairs, and hospice care. Furthermore, if you need a blood transfusion, the cost of the blood is completely covered. Most individuals, when they reach the age of 65, are automatically enrolled in Part A.

You need to bear in mind that this part covers hospital inpatient costs and the fact that you visit a hospital doesn’t make you an inpatient. You are considered an inpatient only when you are admitted to a hospital with a doctor’s order; otherwise, you are considered an outpatient.

Also, if you are unable to get to a hospital or skilled nursing facility, this part covers some home healthcare services, too. All you need to pay is a deductible every year, and coinsurance. Also, if you or your spouse receive Social Security benefits you don’t even need to pay the monthly fee and you will be automatically enrolled.

On the other hand, if you are still working or for some reason you don’t qualify for these benefits, you will have to pay a monthly fee.

 

Part B

Part B is also called medical insurance and it covers outpatient care. This refers to your visits to a doctor’s office, tests, and some preventive care like diabetes tests and depression. Most people prefer to have both Part A and Part B to make sure that they get the most coverage. For instance, if you are admitted to a hospital, you need both parts in order to be fully covered.

Ambulance and emergency department services, as well as influenza and hepatitis vaccinations, are also under Part B. Moreover, this plan also covers electrocardiograms, medical equipment, and certain drugs. For those who have eye problems, they should know that some prescriptions for eyewear are also covered.

In order to benefit from Part B, you must pay a monthly fee and a fixed deductible which you must pay every year before Part B pays for your care. For some services like doctor’s appointments, physical therapy, diabetes supply, wheelchairs, or other care, you will have to pay 20% of the Medicare-approved amount.

You need to remember that you need to pay the deductible before being able to pay 20% of the care you get. There are cases when doctors will not agree to accept Medicare-approved amounts, and you will have to pay a little more than expected. Sometimes you might even have to pay the full cost for the service and the doctor’s visit.

 

Part C

This part is also called Medicare Advantage and is a Medicare health plan that you can also get from certain private insurance companies. For an additional cost, you will get more coverage that will offer you the much-needed peace of mind. Besides the benefits you get with traditional Medicare, you may also enjoy prescription medical coverage.

Moreover, some of these plans will also offer coverage for dental, vision, hearing, and various wellness programs. In order to be eligible for Part C, you must be enrolled in Plan A and Plan B. Being enrolled in this plan is not enough to enjoy maximum benefits; you have to follow all of the plan’s rules, too.

One of the most important rules is to use the doctors that are in the plan’s network; otherwise, you might have to pay for that service. Also, it is important to compare plans before you choose the one that you believe it to be right for you.

Because plans have different limits on the amounts you need to pay from your own wallet, it is always a good idea to take your time before you make a decision. It is always better to be on the safe side and to avoid regretting your decision later on.

Part D

Also known as the Medicare prescription drug benefit, this plan pays for prescription drugs. You can join any private health plan that you find more suitable for your needs as it is not mandatory to be from Medicare. Every private insurance company decides which drugs to cover and how much they will cost.

That is why you need to do thorough research of the market before deciding which insurance company to choose. You must pay attention to every single detail of each plan and read carefully all the information before you choose one. You will still need to pay a monthly fee, usually referred to as the premium, even if you are already paying for Part B.

Another way to get all the benefits of Part D is to join a Medicare Advantage plan that has a prescription benefit. Furthermore, you can get a Medicare Cost Plan with prescription medicine benefits. The best part about these plans is that the premium you pay includes the medicine coverage.

In order to avoid paying penalty for joining late, you will need to get the Part D plan as soon as you become eligible. Even if this plan is optional, most people choose to get it because they have the certainty that their medications are covered.

 

 

 

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