Medicare consists of different parts that offer various coverage. By dividing up the coverage, each policy’s benefits are clear and billing is made simple. Understanding the different parts of Medicare is extremely important in choosing the right policy and deciding which type of coverage will work best for you.
Medicare Part A
Medicare Part A covers many different things, starting with hospital inpatient care. To qualify, you must have been admitted to the hospital under instruction from your doctor. They will need to authorize that the care you’re receiving is necessary and must be done in the hospital environment.
Skilled nursing facility care is also covered under Part A. Most of the people who are admitted to a skilled nursing facility must have had a qualifying hospital stay. Some situations, such as those that are COVID-19 related, may not need a hospital stay prior to admittance.
Nursing home care is covered under Part A, but there are very specific qualifications the stay must meet. To summarize, the care must be deemed medically necessary. Neither custodial nor long-term care is covered through Part A.
Part A’s coverage extends to hospice care, which requires the individual to be expected to live no longer than six months. Accepting hospice care means no longer choosing treatment and instead focusing on comfort. There are many things that are covered under hospice care to provide support for both the patient and their family or caretaker(s).
The last section which Part A covers is home health services. Part-time nursing care, both physical and occupational therapy, speech-language services, and part-time home health aides are all covered by Part A in most situations.
The most important thing to remember about Part A is that all services are intended to be temporary.
Medicare Part B
The two areas covered by Part B are
- Medically necessary services
- Preventative services
Medically necessary services can include a wide variety of things, intended for both diagnosing and/or treating a medical condition. Before receiving treatment, make sure that the healthcare provider accepts your insurance and is Medicare-approved. Doing so will make sure you have the lowest bill possible.
Ambulances, some durable medical equipment, and mental health services all are included within Part B. Because of the wide variety of options available, Part B is recommended. Some may be automatically enrolled in Part B during their Initial Enrollment Period.
Medicare recognizes that the best type of treatment is early treatment. Because of this, preventative services are covered by Part B. Beneficiaries should utilize the provision of preventive services, as they can save lives.
Enroll with Cornerstone Senior Advisors
If you’re considering enrolling in Original Medicare, our professionals are ready and able to assist. We can walk you through the enrollment process, discuss how your coverage can be used, and answer any questions you may have.