Medicare can be confusing when combine with other health problems. While the insurance maze can be difficult to navigate, an estimated 57 million people received this program in past years, which is more than a sixth of the nation’s population. Below are a brief overview and some answers to some commonly asked questions regarding Medicare and home health care.
- Who qualifies?
Medicare is a national health insurance program provided by the U.S. government for those who are:
– Above 65 years
– Below 65 with certain disabilities
– Diagnosed with End Stage Renal Disease (ESRD), a form of permanent kidney failure requiring dialysis or a kidney transplant
- What types of services does Medicare cover?
This healthcare program has four different coverage sections which are Part A, B, C, and D. “Original Medicare” consists of Part A & B, while Part C is known as “Medicare Advantage Plan”. These four parts are summarized briefly:
– Medicare Part A: Hospital Insurance
* Part A covers care while in the hospital as well as health care in skilled nursing facilities, home health care, and hospice.
– Medicare Part B: Medical Insurance
* This covers doctor’s visits. Additionally, Part B covers hospital outpatient care, durable medical equipment (like intravenous infusion devices), and home health care services.
– Medicare Part C: Medicare Advantage
* This combines health plan options you purchase from other private insurance companies approved by Medicare. It also assimilates Medicare Prescription drug coverage (Part D) and can be tailored to include extra benefits at an extra cost.
– Medicare Part D: Medicare Prescription Drug Coverage
* This covers the prescription of Medicare-approved prescription drugs and can lower the cost of other medications. Similar to Part C, Medicare-approved private insurance companies also run Part D.
- Why do I need to select between Medicare plans?
The selection of “Original Medicare” (Parts A & B) requires monthly premiums payment for part B and may necessitate additional coverage to pay deductibles and coinsurance to see physicians, hospitals, and other providers who accept Medicare. If you require Prescription drug coverage, you must pay a monthly premium to join the Medicare Prescription Drug Plan (Part D). The “Medicare Advantage Plan” also requires the monthly premiums payment in addition to the Part B premium & a copayment for in-plan doctors, hospitals. If recommendation medications are not covered by the supplemental coverage, you have the option of combining the Medicare Prescription Drug Plan (Part D).
As with prescription medications, you can purchase supplemental coverage to cover services not covered by Medicare. The “Original Medicare” plan allows for the option of buying Medicare Supplemental plans (Medigap), while the “Medicare Advantage Plan” does not.