MEDICARE COSTS Flashcards
Your Costs:
Original Medicare contains two parts: Part A and Part B. Patients must pay monthly premiums and other costs such as deductibles, copays, and coinsurance. The amount you have to pay may vary each year in January. For Part A, most people don’t have to pay any premiums since they paid a tax during their working years. However, everyone must pay the premium for Part B to keep their coverage.
You need to pay a deductible before Medical begins chipping in for your medical expenses. This amount can differ depending on the type of care you receive, for example, inpatient hospitalization or a doctor’s office visit outside a hospital setting. In addition, there might be services not covered by Medicare at all, meaning you will have to bear the total cost yourself. Therefore, checking with your doctor before receiving a service is important to ensure your plan covers it!
In addition to their premiums and co-payments, individuals with Original Medicare are also responsible for the total cost of any services that Medicare does not cover.
Medicare does not cover everything:
Unfortunately, the program does not cover many services that seniors consider “necessary”.
For example, it does not cover vision exams, most dental services (including dentures), and hearing aids. It does not cover an annual physical exam.
Most notably, it also does not cover Long Term Care.
Most of these services are considered “custodial care.” They include basic daily activities like help with walking, getting in and out of bed, dressing, bathing, toileting, shopping, eating, and taking medicine. Part A only covers up to 100 days of skilled nursing home care during a benefit period following a hospital stay. If you need long-term custodial care after your hospital stay has ended, Medicare will not pay for it. Additionally, it does not cover homemaker services or private-duty nursing care.
