Medicare can seem a bit scary and even confusing to most people. However, if you take it piece by piece instead of chunks at a time, it will become more friendlier to you as you begin to understand.
Once you learn the basics of Medicare. You’ll be well on your way to helping your friends and family members understand as well.
I’m your personal Licensed a Medicare Advisor. and I’m here to make your life a bit simpler.
Let’s quickly talk about the different parts to Medicare.
Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
Original Medicare (Part A Part B) allows you to use any doctor or hospital anywhere in the U.S. that accepts Medicare.
Medicare Part A (hospital coverage) pays for:
- care in a hospital.
- care at a skilled nursing facility (with a referral from a medical professional) only after a hospital stay.
- home health care.
- hospice care.
- all but the first three pints of blood each calendar year. (MEANING, YOU MUST PAY FOR THE 1ST 3 PINTS)
Medicare Part B (medical coverage) pays for the following minus patient 20% responsibility.
- doctor visits.
- home health care.
- lab services.
- outpatient hospital care.
- durable medical equipment and supplies.
- preventive health services, like exams, health screenings, and vaccinations.
In most cases, you’ll need to use doctors who are in the plan’s network. • Most plans offer extra benefits that Original Medicare doesn’t cover—like vision, hearing, dental, and more.
Medicare has a Part A benefit which covers SOME, not all of your hospital expenses. For example, if your doctor decided you needed to go into the hospital and you had the “Red, White, and blue” card and the card had PART A, then some of your expenses would be covered under this plan.
Complete and mail the following form to file for Part B
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS017339
Search for Your Local Social Security Office
https://secure.ssa.gov/ICON/main.jsp
Services Medicare doesn’t cover
- Most long-term care. Medicare only pays for medically necessary care provided in a nursing home.
- Custodial care, if it’s the only kind of care you need. Custodial care can include help with walking, getting in and out of bed, dressing, bathing, toileting, shopping, eating, and taking medicine.
- More than 100 days of skilled nursing home care during a benefit period following a hospital stay. The Medicare Part A benefit period begins the first day you receive a Medicare-covered service and ends when you have been out of the hospital or a skilled nursing home for 60 days in a row.
- Homemaker services.
- Private-duty nursing care.
- Most dental care and dentures.
- Health care while traveling outside the United States, except under limited circumstances.
- Cosmetic surgery and routine foot care.
- Routine eye care, eyeglasses (except after cataract surgery), and hearing aids.
The Centers for Medicare and Medicaid Services (CMS) publishes the Medicare & You handbook that describes Medicare coverages and health plan options. The handbook is mailed to Medicare beneficiaries each year. You can also get a book by calling 800-MEDICARE (800-633-4227).