What Does Medicare Part-A And Part-B Pay For?

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The complicated world of Medicare can quickly be explained in simple ways as follows:

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How is What Does Medicare Part-A And Part-B Pay For?

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Medicare PART-A: This is the hospital portion of the plan, and it pays for the following

o Inpatient hospital care
o Hospice care
o Some skilled nursing care
o Home health care

Before we go any further, you also need to learn what "benefit period" is: Benefit period refers to the number of days you receive care in a hospital or skilled nursing facility. Medicare uses this count to determine the amount it will pay per a benefit period. Three factors determine your benefit period:

1. The length of stay in skilled nursing facility
2. The length of your stay in hospital
3. The length of release before you return to a skilled facility or a hospital

Your benefit period begins the day you are accepted to a hospital and continues as long as you: (1) Stay in a hospital (2) Transfer to a Medicare approved skilled care facility within 30 days of your stay. And it ends if you don't receive hospital or skilled nursing care for consecutive 60 days whenever you leave hospital or skilled nursing home care.

How Medicare pays for Part-A (remember, this is only the cost of your hospital or skilled care facility, it doesn't include any doctors, nurses or the cost of your prescription drugs.)
o Days 1 - 60: You pay ,068.00 as your deductible
o Days 61 - 90: You pay 7.00 per day as your co-pay
o Days 91 - 150: You pay 4.00 per day as your co-pay, up to 60 days. These 60 days are your Lifetime Reserves. When you exhaust them, they will not renew.
o Days 151 and over: If you have any Lifetime Reserves left, you will pay 4.00 per day until you exhaust your Lifetime Reserves. If you don't have any Lifetime Reserves left, you will pay all Part-A expenses after the 90th day.

How Medicare pays for Skilled Nursing Care
o Days 1 - 20: You pay nothing
o Days 21 - 100: You pay up to 1.50 per day as your co-pay
o Days after 101 and over: You pay all costs

Medicare Part-B: This is the medical insurance portion of Medicare and it pays benefits for doctors' services, outpatient hospital services, medical services and supplies.
o You pay .40 monthly premium (automatically taken out of your social security check)
o You pay 5.00 as your deductible
o After the deductible, you pay 20%, and Medicare pays 80%
o You pay 15% more for assigned specialist

Please note that the explanation of the rules for Medicare paying for Part -A and Part - B are beyond the scope of this article.

It should also be mentioned that since Medicare has considerable benefit limitations, there are private insurance policies called Medigap Insurance Plans where these insurance policies complement the gaps that Medicare does not cover. It is highly recommended to consult a Medicare Specialist to coordinate which one of these Medigap Plans is suitable for your personal needs.

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