Medicare Benefits

Medicare has several parts including Part A (Hospital Insurance), Part B (Medical Insurance). Part B helps cover doctors’ services, outpatient services and other medical components that are not covered by Part A. It is important to note that Medicare does not cover all of the expenses incurred by the program recipient. Beginning in 2006, Medicare Part D was added. Part D provides coverage for prescription drugs. Medicare also covers medical devices such as powerchairs, wheelchairs and mobility scooters.

 

Part A: This section of Medicare addresses hospital stays. It will also pay for some nursing home stays for a certain amount of time after a hospital visit. There are specifications related to the nursing home stay and Medicare will usually pay for therapy that is related to the hospital stay. For example, a broken hip would qualify a person for a two week stay in a nursing home for two weeks of therapy. Most people don’t pay a premium for Part A. It is a benefit accrued through payroll taxes. Medicare Part A helps cover hospital stays, critical access hospitals, and short-term nursing care. It also helps cover hospice care.

 

Part B: If you benefit from Part B, it may be deferred as long as the beneficiary or the spouse is still working. Medical insurance (Part B) pays for physicians’ services and some other services not directly covered by Part A. This portion of Medicare is optional and during 2006 you paid $88.50 a month for this benefit. This part helps cover doctors’ services and outpatient care. It also helps cover physical and occupational therapists and some health care.

 

Part C: Medicare Advantage plans are addressed in Part C of Medicare plans. For the last 20 years, Medicare beneficiaries have the option to receive their Medicare benefits through private health insurance plans. Medicare Advantage plans offer comparable coverage to Part A and B but also offers Part D coverage. Part D coverage includes prescription drugs.

 

Part D: The new Medicare Prescription Drug, Improvement and Modernization Act, was enacted in 2003. This Act requires the Social Security Administration to add additional Medicare-related benefits. The Centers for Medicare and Medicaid Services are working together to assist those with limited income by helping them pay for prescription drugs. This is Part D of the Medicare program and addresses benefits for prescription drugs. This is a complex benefit for senior adults to traverse through and make decisions on that will affect their drug costs and benefits. To receive this benefit a person with Medicare must enroll in a stand-alone drug plan or have the Medicare Advantage plan. Most people will pay a monthly premium for this coverage. This coverage is available to everyone with Medicare. It helps lower drug costs with beneficiaries choosing the drug plan they want.

 

Medicare processes over one billion claims each year. It is the nation’s largest purchaser of managed care. Medicare accounted for almost 13% of the entire Federal Budget in 2003.