Understanding Medicare and its Supplemental Plans
There are a few different plans for Medicare, so it can be confusing to tell which ones cover what services. To make sure that you get the coverage you need, it’s important to understand what coverage you’ll get from each plan. Medicare plans are broken into Part A, Part B, Part C, and Part D. The original Medicare plans are Part A and Part B, while the supplemental plans are Part C and Part D.
What services does Medicare cover?
The two main plans for Medicare cover different things, here’s what each one covers.
Medicare Part A coverage
Usually with Part A, you can get rehabilitation, mental health, nursing homes, and hospice care covered, but you may have to meet certain qualifications. Here’s what Part A covers:
· Mental Health Care – You can get your mental health services covered as a hospital inpatient, whether you’re in a general hospital or a psychiatric hospital.
· Inpatient Hospital Care – It will cover a semi-private room, meals, general nursing services, medical supplies, and some medications.
· Skilled Nursing Facility Care – You can have room and board, and a variety of skilled nursing services covered, such as tube feedings, wound care, some medications, and other services. Qualifications include having spent at least 3 days in a row as a hospital inpatient within 30 days of entering the skilled nursing facility.
· Hospice Care – In most cases, Medicare will cover your hospice care for as long as your doctor certifies that you need it.
· Home Health Care – You may have up to 100 days of part-time limited home health care services covered by Medicare. To qualify, you must have been a hospital inpatient for 3 days in a row within 14 days of beginning home health care.
Medicare Part B coverage
While Part A focuses more on inpatient care, Medicare Part B covers medical and outpatient services. Here’s what it covers:
· Therapy like physical, occupational, or speech therapy administered by a Medicare-certified therapist.
· Medically necessary services from a licensed healthcare professional, like preventative care, annual wellness exams, vaccinations, and some kinds of cancer screening.
· Diagnostic tests like x-rays and lab work.
· Certain medications that you would receive in a doctor’s office, like immunosuppressant drugs, anti-cancer medications, or others that you wouldn’t take at home.
· Durable medical equipment like wheelchairs, oxygen tanks, or walkers. You should be able to rent or buy this equipment from a Medicare-certified supplier.
· Ambulance services, in emergency cases where it is medically necessary to have ambulance transportation.
What do Medicare supplement plans cover?
The two main Medicare supplement plans are Part C and Part D.
Medicare Part C coverage
Medicare Part C is known as the Medicare Advantage plan. It doesn’t come standard with government health insurance, and it allows you to get your Medicare coverage through a private insurance company that is contracted with Medicare.
Any Medicare Advantage plan has to offer you at least the same level of coverage as a Part A or Part B plan, and often Medicare Advantage plans are combined with regular Medicare coverage to allow for prescription drug coverage.
In some cases, Medicare Advantage plans can offer more coverage options than a standard Medicare plan, like in including coverage for routine dental and vision care.
You’ll pay for your Medicare Advantage premium in addition to the premium of the standard Medicare plan you have. Medicare Advantage plans usually have copayments or coinsurance, and may have annual deductibles as well.
Medicare Part D coverage
This is an optional Medicare supplement plan that covers prescription drugs. You will possibly have to pay for coinsurance or copayments, as well as monthly premiums and annual deductibles. Through a private insurance company, you can get Medicare prescription drug coverage in two types:
· As a part of your Medicare Advantage Prescription Drug plan. Or
· As a solitary Medicare Part D prescription drug plan if you’re enrolled in Medicare Part A or Part B.
Plan IV | Medicare Plans and Supplemental Medicare Plans
If you or your family need more medical care than what is covered in standard Medicare plans, and you want to cut down on the accumulating costs, ask us about our Medicare supplemental plans. We offer a wide range of Medicare supplemental plans to suit your specific healthcare needs. You shouldn’t have to be overwhelmed in costs just to get the care you need to be healthy and happy, let us make sure your care is covered at a reasonable rate. To learn more about our Medicare supplemental plans, give us a call at (248) 689-4910 or send in an online contact form today!
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