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All about Medicare plans and what they cover

All about Medicare plans and what they cover

Medicare is a health insurance plan that is provided by the federal government to its senior citizens. Anyone aged 65 or above is eligible to get the benefits of Medicare if they wish to enroll in any of the plans. However, it is also for young people living with certain disabilities and those suffering end-stage renal disease, who might require kidney dialysis or transplant. There are different parts of Medicare, so let’s take a look.

Medicare Part A

Part A, known as the inpatient or hospital coverage plan, is a coverage plan for inpatient hospital care, skilled nursing facility care, home health care, and even hospice care. The patient is covered for up to 90 days in a general hospital that falls under the Medicare plan, and this also includes 190 days coverage for admittance to a Medicare-approved psychiatric facility. If the patient is in a skilled nursing facility, they are covered for their medications, wound care, and tube feedings, along with room and board charges levied. This is applicable for up to 100 days. This timeline is applicable to the home health care coverages as well.

Medicare Part B

Also known as outpatient or medical coverage, this includes services like those needed from a professional healthcare worker or skilled nursing needed at home, including therapy care. You may also get coverage for Durable Medical Equipment, which includes wheelchairs, oxygen tanks, or walkers that can be used repeatedly at home for medical purposes. If you need emergency transportation to and from the hospitals, you can ask for that coverage under Part B. There are also some preventive care services, including counseling and screening, which may help prevent further illness or detect any conditions in the future. Chiropractic care, lab tests, and x-rays are all included in the above.

Medicare Part C

Medicare Advantage or Medicare part C is the best alternative to the original Medicare run by the federal government. However, to acquire the benefits of this Medicare Advantage, you will have to have enrolled in Part A and B. Along with the regular medicare coverage, this plan also includes services like dental care and eye care. You may also avail coverage for additional costs like meal delivery services or transportation needed to travel to and from your doctor’s office. Installing wheelchair ramps or even shower grips can also be added to the cost as part of the Part C plan.

Medicare Part D

The Prescription Medicine Benefit plan is beneficial for covering most of the outpatient prescription medicines. There are some private companies that offer this plan as a stand-alone, apart from the original Medicare plan. However, if you avail of this through the original Medicare, its benefits can be added through part C. This Part D comes with a formulary, which is basically a list of prescribed medicines that come under this plan. Make sure to go through the list to ensure that it covers the prescriptions needed. If your medicine is not on the list, you either have to pay for it by yourself, or you may file for an appeal.

Here are the conditions for which there must be at least two medicines that need to be included: Antidepressants, immunosuppressants, anticancer medication, anticonvulsive treatments for treating seizures, HIV/AIDS medications, antipsychotic medicines. There are also certain vaccines that must be included in the list. Make sure to get all the details before you enroll in any of the plans.