Medicare covers hospitalizations and other medical services for those aged 65+. It’s a federal medical insurance program and people with certain disabilities are also eligible.
There are three main parts of traditional Medicare. They’re parts A, B, and D.
What Medicare Covers in Part A
Medicare Part A covers inpatient stays. It also covers nursing care with a qualifying stay.
Inpatient Hospital Stays
So, how do you know if your hospital stay is qualified? Above all, it’s important to know how it’s being classified. For example a stay is classified as inpatient if a person is admitted to the hospital and stays there for a minimum of 3 nights.
However, the physician may have you stay overnight for “observation.” Observation stays don’t count towards your 3-night minimum. For more information click here.
Skilled Nursing Facility Stays
Once you’ve had an inpatient stay at a hospital you may need further treatment. So, your doctor may recommend a stay at a skilled nursing facility.
The first 20 days of your skilled nursing stay are often covered by Medicare. Also important to know, stays beyond 20 days will require a copay. Your coverage can last up to 100 days or until your condition is stable. Keep in mind, the average length of stay in the Cincinnati market is 23 days. For more information click here.
Hospice Care
Your Medicare plan may cover hospice services. However, it requires that you use a Medicare-certified provider. For more information click here.
Home Health Care
Also covered by Medicare is Home Health care. Home care services are covered when they’ve been ordered by your physician. For example, you may need additional care to recover after a hospitalization.
Or help with an ongoing medical condition. For instance one that may include nursing services or therapy. For more information click here.
What Medicare Covers in Part B
Medicare Part B covers medically necessary services. And, it also covers preventative care.
Outpatient Care
What is outpatient care? It’s a procedure that doesn’t involve an overnight hospital stay. Therefore, patients leave once the procedure is done and recover at home. For more information click here.
Medical Supplies
Medicare doesn’t cover all supplies. Here’s a short list of what it does cover.
- Blood sugar monitors
- Canes
- Crutches
- Walkers & scooters
In addition to these, you can find a full list here.
Preventative Services
Medicare doesn’t cover all preventative services so here’s a short list of those covered. For the full list click here.
- Annual physical exam
- Mammogram
- Colonoscopy
- Diabetes screening
- Bone mass measurement
What Medicare Covers in Part D
Prescription Drug Coverage
There are two ways to get Medicare prescription drug coverage. Either Medicare Part D or the Medicare Advantage Plan. To clarify, the Medicare Advantage Plan is like an HMO or PPO. To learn how the coverage works click here.
Not Covered by Medicare
Finally, it’s important to understand what won’t be covered by Medicare. Here’s a list of the top services that Medicare doesn’t pay for. For more details click here.
- Long-term care
- Private duty services in your home
- Transportation
- Meals
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