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Medicare Coverage – Understand The 4 Parts of Medicare And Get The Best Care

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In this article, we are going to have an overview of Medicare coverage and talk about the differences between parts A and B. Medicare Part B is the part of Medicare that covers medical services, medical supplies, and doctor visits. The government provides it to certain individuals who meet the qualifying guidelines.

This insurance covers expenses incurred for doctor visits, outpatient, and home health care. Equipment to be used by patients for therapeutic purposes can be covered. Also, canes, crutches, and wheelchairs are just some of the medical equipment Medicare Part B covers.

Outpatient Care Medicare Coverage

Outpatient care covered by Medicare Part B is the doctor care and services you receive in a hospital. However, it does not require an overnight stay in the hospital. Examples of services covered as an outpatient may include surgery, lab work, and medicine administered intravenously. In addition, it covers EKGs under outpatient care. Also, an Emergency Department visit is considered an outpatient service covered by Medicare Coverage.

Home Health Care Medicare Coverage

Medicare Part B will pay for a nurse to come to your home. The nurse will monitor your illness, give injections if necessary, and administer wound care to you if needed. First, the nurse will take your vital signs. She will make sure you are taking the medication you should take when you should take it. Home care also includes physical therapy, speech therapy, and other types of healthcare services. However, home health care only covers nursing care if they gave it on a part-time and on and off basis.

Medical Equipment Covered by Medicare Part B 

Aside from canes, crutches, and wheelchairs, Medicare Part B covers much more. Examples of equipment covered include:

  • Glucose monitors
  • Glucose test strips
  • Portable toilets
  • CPM machines
  • Hospital beds
  • Pumps for suction
  • Pumps for administering drugs
  • Accessories for people needing oxygen
  • Walking equipment

Someone must medically need the medical equipment prescribed in order for it to be covered by Medicare Part B. Your home is where the equipment must be. In addition, the equipment must only be for a medical purpose and used for that medical purpose.

Does Medicare Part B cover Preventive Services?

Medicare Part B covers preventive services. Some services may be a onetime screening, while they may cover others more than once. Some of the preventive services include screenings for the following:

  • bone density
  •  heart disease
  •  certain types of cancer
  •  diabetes
  • glaucoma
  • depression

Besides screenings, they cover preventive shots such as flu, hepatitis B and pneumococcal with Medicare Part B. Also, a preventive wellness visit every year and nutrition therapy services is part of it.

Who Qualifies for Medicare Part B?

If you have Medicare, you qualify for Medicare Part B. Remember, though that you may not be able to get coverage for Medicare or Medicare part B until you are 65 years old. Certain individuals younger than that can get coverage if they are disabled. Someone who requires dialysis because may also qualify for Medicare and Medicare Part B.

Do I have to Get Medicare Part B and Is there a Fee for it?

Medicare Part B is not something you must have. If you decide to enroll in this plan, you will have to pay a fee. The majority of people who have Medicare Part B pay a standard amount in premiums. However, people with higher incomes can sometimes have higher premiums to pay. Note that if you do not enroll for Medicare Part B when you do become eligible for it, you could be penalized, and you may be subject to a late enrollment fee.

Medicare Coverage-Understanding Parts C & D and Get the Best Care

They break Medicare coverage down into two parts; Part C, also known as Medicare Advantage, and Part D, the prescription drug coverage. Like all Medicare benefits, Medicare Parts C and D are federally regulated.

The legal requirements for these plans may change every year depending on the current legislative agenda of Congress or changes to our nation’s health care laws or regulations.

4 parts of Medicare

Part C: Medicare Advantage Plans

A Medicare Advantage plan is a type of plan that you can join instead of just having regular original Medicare. It was created to give seniors more benefits and a better choice for their Medicare coverage. The Centers for Medicare & Medicaid Services (CMS) approves private companies to provide Medicare Advantage Plans to compete with the government’s original program. These plans are sometimes called “Part C” or “MA Plans.”

What is Medicare Part C Used for?

Medicare Part C is an alternative to traditional Medicare coverage that allows you to seek care from private health insurance companies. Many people enroll in Medicare coverage Parts A and C, as they can provide additional benefits not covered by Original Medicare.

These benefits include dental and vision plans and prescription drug coverage. If you choose a plan offered through Medicare Advantage, your monthly premium is often lower than it would be for Part B. Medicare Advantage plans are sometimes referred to as “MA Plans.”

How Does Medicare Part C Work?

The biggest advantage of having a Medicare Advantage plan (Part C) is you can choose your doctor, unlike with traditional Medicare coverage. This is because the health insurance company you choose will have its network of doctors apart from the original Medicare system.

Is Medicare Part C Expensive?

Medicare Part C is more expensive than traditional Medicare because of its range of care. The government contributes less towards Part C premiums because the coverage isn’t as expansive as regular Medicare. However, you can still save money on your monthly premium- for example, if you choose a plan that offers prescription drug coverage in its benefits package.

Are All Part C Plans the Same?

No, many types of Medicare Advantage Plans differ from one another. These plans may offer different benefits and costs to accommodate particular circumstances. For example, some plans pay for routine vision and dental care while others do not. You may be able to choose a plan with prescription drug coverage or without it depending on which one you feel would suit you best.

What Is Medicare Part D Used For?

Medicare Part D is also known as Medicare Prescription Drug Coverage. This part of the health care system provides coverage for prescription drugs, but only if you join a plan offered by an insurance company. Plans like these are required to provide affordable access to necessary medications.

How Does Medicare Part D Work?

Medicare Part D works by using insurance companies to provide you with affordable prescription drug coverage to get the care needed for your health.

You pay a monthly premium and choose from an extensive list of medications offered through specific policies. Once enrolled, Medicare coverage Part D provides different levels of coverage depending on which policy you’ve chosen. It can be divided into four different categories:

  • Standard- This is the lowest level of coverage, but it has a deductible.
  • Enhanced- This type of plan has lower copays than standard, but you must meet certain requirements to enroll.
  • Premium- You will be required to pay an extra premium to enroll in this type of plan, but it has lower copays.
  • Low-income Subsidy- This is for people who are low income and would like to enroll in Medicare Part D but don’t have the money to do so.

Are All Part D Plans the Same?

No, insurance companies have unique plans for people to choose from. This means that all aspects of the plan- including copays and premiums- can vary depending on which company you choose. These factors will determine how much you pay every month. For example, some may require you to pay a higher premium because of the type of medication they cover or because of your age.

How Do I Choose a Medicare Part D Plan?

You can enroll in a Medicare coverage Part D plan if you decide to join a plan offered by an insurance company. If you’re already enrolled in Original Medicare, you must first join a Medicare Advantage Plan and opt for either a stand-alone or a Medicare Prescription Drug Plan.

You can enroll in a plan any time, but it is recommended that you enroll during the Annual Enrollment Period from October 15 to December 7. Enrollment takes place through a Federal Health Insurance exchange website, known as “Medicare.gov”

How Much Does Medicare Part D Cost on Average?

The average person pays a monthly premium ranging from $35 to $100. However, the amount you spend will depend on which type of plan you decide to join and whether or not it is stand-alone or has Medicare coverage Part C benefits besides D coverage.

Costs for deductibles, copays, and premiums can vary depending on how much the plan covers and how much you need. You might have to pay a higher deductible or premium depending on which plan you sign up for.

How Much Does Medicare Part D Save People?

In 2008, it was reported that about 1.5 million low-income individuals saved about $1.6 billion annually because of the help of Medicare coverage Part D. Overall, there were about 1.7 million people who saved almost $2 billion in prescription drug costs because of the Medicare Prescription Drug Benefit. Medicare coverage has become more affordable and accessible.