Need Help Understanding Your Medicare Coverage?

Medicare coverage is a critical source of health insurance coverage for over 40 million people. However, understanding the many components of Medicare can be a source of worry and concern for many people who are afraid that checking the wrong box may make them ineligible for some important medical coverage.

With a little guidance, you can be sure that you are making wise choices in your Medicare coverage.

What is Medicare?

Medicare is the federally supported health insurance program that helps seniors 65 and older and disabled Americans pay for health care. The program consists of two main parts. One for hospitals and one for medical insurance, Part A and Part B and two additional parts that provide flexibility and prescription drugs, Part C and Part D.

What Does Part A Cover?

Part A Medicare coverage, also called Hospital Insurance (HI), helps pay for 90 days of hospital care per "spell of illness", after a minimal annual deductable is satisfied. Covered medical care during a hospital stay includes such things as:

Meals
Testing
Semi-private room
Supplies
Operating room, intensive care unit, coronary care unit
Drugs furnished by the hospital
Blood transfusions after first three pints

Part A also covers home health care, when deemed necessary. This includes services such as physical therapy, occupational therapy, and speech therapy. Care in a skilled nursing facility and necessary medical equipment such as walkers and wheelchairs. Part A coverage is generally available without a co-pay.

What is Medicare Part B?

Medicare coverage Part B, also called Supplementary Medical Insurance (SMI) helps cover outpatient services such as office visits, ambulance services, and many preventative services. When you are enrolled in Part A, you are automatically enrolled in Part B unless they choose to opt out of Part B coverage. Part B enrollees pay a monthly premium that equals on average, one forth of the costs of part B services.

What is Medicare Part C?

Part C, or the Medicare Advantage Plan, combines part A and B and gives the enrollee the opportunity to choose from an approved list of health care providers. In many cases, Part C is a lower cost alternative to the Original Medicare Plan.

What is Part D Coverage?

Part D is a stand-alone prescription drug coverage plan. Within plan D, there are several different drug plans from which to choose. While all medically necessary drugs are covered, most enrollees will pay a premium for this service.

If you are approaching Medicare eligibility and confused about your options, contact your local Health Insurance Counseling and Advocacy Program (HICAP) for unbiased healthcare counselors.

Royce Vangoff found out all he could about medicare coverage in Denver to make sure they have the coverage they need. If you want to find out about medicare in Colorado, Rocky Mountain Health Plans (RMHP) can help.