ABC’s of Medicare Part A & B

The following outline provides the basics of Medicare Part A and B:

Medicare Part A:

• Provided at no cost to most upon reaching age 65.

• Coverage automatically goes into effect on the first day of the month in which you turn 65.

• Coverage provided in full for 60 days of in-patient hospital stays with a deductible per confinement (currently $1,184). Hospital stays beyond 60 days are covered subject to a per day deductible that varies by length of stay.

• Coverage for skilled nursing care facilities following a hospitalization at 100% for the first approved 20 days. For days 20 to 100, you pay $148 per day and Medicare Part A picks up the rest. No coverage beyond 100 days.

• Medicare Part A is NOT designed to cover long term stays in a nursing home.

Medicare Part B:

• An elective coverage purchased through the Social Security Administration. Monthly premiums can range from $105 – $335 depending on the adjusted gross income of the individual or joint tax filing.

• Covers medically necessary (including ER visits) and Medicare approved services billed by physicians and other non-hospital associated providers.

• Coverage has an annual deductible (currently $147) and reimburses approved services at 80% of the Medicare approved cost guideline.

This is summary of the general features of the various levels of coverage available to those of age 65 and older. The gaps and potential for large out of pocket costs can be covered by various Medicare supplement plans which we will cover in our next newsletter.

 

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