What Does Medicare Pay For
Medicare is the most commonly taken health insurance plan. It is administered by the federal government. It was setup to assist the people when they get aged to bear their medical expenses. Everyone 65 and above is eligible to enroll to this policy. People below 65, but suffering from disability and end-stage renal failure needing kidney transplantation or dialysis are also eligible to take this policy. The Medicare Health Insurance is divided into Part A, Part B, Part C and Part D. They are otherwise known as Hospital Insurance, Medical Insurance, Medicare Insurance and Prescription Drug Coverage. Each of these plans offer different benefits and pay for different expenses.
The Medicare Health Insurance Part A provides for in-patient care in hospitals, for skilled nursing services, hospice care and home healthcare services. It also covers blood for transfusion excluding three pints every calendar year. Majority of people opting for this plan will not be required to pay the premium as their spouse or they themselves would have paid Medicare taxes during their employment period. But the payment of co-insurance and deductible charges is compulsory for everyone. Medicare does not pay for long term treatment or hospitalization. It will provide good coverage for 60 days of hospitalization. If the hospitalization still continues after 60 days, then it will provide lesser coverage. And finally, if the hospitalization surpasses 150 days, Medicare stops giving coverage. Other than that, Medicare will also provide 100 % cover of the approved amount for stay at any skilled nursing facility for 20 days. Even here the coverage is weakened after the first 20 days of stay. And Medicare completely stops giving cover after the expiry of 100 days. The Part A plan provides cover for semi-private rooms, anesthesia and regular nursing services, operating and recovery room cost, rehabilitation services, intensive care, lab tests, x-rays and drugs.
The Part B covers doctor’s services, medical supplies and medical durable equipments. Here, Medicare pays 80 % of the approved amount for outpatient hospital expenses, doctor’s fees and medical expenses. It also provides coverage for physician’s services, diagnostic tests, medical and surgical services, radiology and pathology, outpatient and emergency room treatment, radiation treatments, mental illness and ambulance transportation. And it provides coverage for certain tests like; diabetes, colorectal cancer and prostate cancer. Other services covered under this plan are mammograms, bone mass measurement, cardiovascular screening and glaucoma. Unlike the Part A plan, everyone enrolled to this plan must pay the premium. And certainly, there is no exception for the payment of deductibles and co-insurance.
Part C is called The Medicare Advantage. It covers everything that the original Medicare covers. But the advantage is that it may offer them at a lower cost with extra services. It also allows qualified people to enroll to HMO, PSO, PFFS, PPO and MSA. It offers several plans, each offering different benefits and costs. Part D provides coverage to people irrespective of their income, health conditions, and prescription drug usage. The P D Ps cover only outpatient drugs for people not having any drug coverage.
For more information on Medicare Supplement Insurance visit Medicare Insurance