Part A Medicare
insurance covers most hospital bills, hospice care and a limited
amount of nursing home and home care. Most people who meet the
Medicare requirements do not have to pay anything to receive Part A,
the hospital insurance, but they may be responsible for certain
deductibles and co-payments once they actually receive services.
If for some reason
your parent or loved one is not enrolled in Part A Medicare insurance,
they should enroll right away; if they wait until they are
hospitalized, they will face a mountain of paperwork and bureaucratic
delays at an already very difficult time.
Part B Medicare
insurance, is the medical insurance portion which covers most doctors
fees (but not annual checkups), medical equipment, diagnostic tests,
outpatient care, and some mental health and rehabilitative therapy.
Most people pay a monthly premium of about $70 for this part of their
Medicare insurance, which comes directly from their Social Security
payments. Beginning in 2007, the premium will be linked to income,
with higher rates for those making over $80,000 per year.
An annual
deductible of about $100 must be met before payments begin. After the
deductibles are covered, the enrollee pays a "coinsurance" or share
the cost of any covered service (about 20% for most services) and
Medicare will pay the rest.
Part B Medicare
insurance is optional. If your elder receive Social Security
payments, they are usually enrolled automatically. If for some reason
they do not want Part B (possibly because they are adequately covered
by another policy), they need to contact a local Social Security
office to let them know immediately. But, there may be penalties if
they decide to change their mind and sign up at a later time.
Services must be
provided by a Medicare-approved hospital, agency, institution, or
company, except in emergencies.
Services must be
"medically necessary", that is they must be ordered by a physician to
diagnose or treat acute or chronic illness.
Services must be
provided within the United States are in some emergency situations,
Canada (some Medicare advantage plans have different rules regarding
travel.)
The original
Medicare insurance plan is divided into two parts: Part A, which
includes hospital insurance; and Part B, which is basically medical
insurance for outpatient services.