Are you aware that your durable medical equipment (DME) may be covered under Medicare? Medicare Part B (Medical Insurance) covers medically necessary durable medical equipment that your doctor prescribes for use in your home. Therefore, Medicare covers items like oxygen equipment and supplies, wheelchairs, walkers, and hospital beds ordered by a doctor or other health […]
Original Medicare
Medicare: Who Pays First?
Who Pays First If I Have Other Health Coverage? If you have Medicare and other health coverage, each type of coverage is called a “payer.” When there’s more than one payer, “coordination of benefits” rules decide who pays first. The “primary payer” pays what it owes on your bills first, and then your provider sends the rest to the “secondary payer” […]
What is the Medicare Donut Hole?
Did you know some Medicare prescription drug plans (PDPs) or Medicare Advantage plans with prescription drug coverage (MA-PDs) have annual coverage limits? If you reach the annual coverage limit, you enter a temporary coverage gap, called “the donut hole.” During this period, you begin to pay a higher percentage for prescription drug costs out-of-pocket – […]
Services Covered by Medicare Part A & Part B
Medicare covers many tests, items and services like lab tests, surgeries, and doctor visits – as well as supplies, like wheelchairs and walkers. In general, Part A covers things like hospital care, skilled nursing facility care, hospice, and home health services. Medicare Part B covers medically necessary services and preventative services. The partial-list of Medicare […]
Your Medicare Benefits: What Is the Limiting Charge?
When you visit a doctor or provider that accepts assignment, you know that they are contracted with Medicare to accept the Medicare-approved amount for a particular service as full payment. If you choose to go to a physician or supplier that does not accept assignment, there are a few things you should know. If your […]
Your Guide to Understanding Medicare Parts A-D
Medicare is a federal health insurance program for people age 65 or older, people with certain disabilities, or people with End-Stage Renal Disease (ESRD). Some people get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) automatically, while others have to sign up for it and manually enroll during their Initial Enrollment Period (IEP). […]
Medicare Part A – Hospital Insurance
Medicare Part A, often referred to as hospital insurance, is Medicare coverage for hospital care, skilled nursing facility care, hospice care, and home health services. It is usually available premium-free if you or your spouse paid Medicare taxes for a certain amount of time while you worked, if you receive or are eligible to receive […]
Medicare Part B Medical Insurance Costs and Services
Medicare Part B is the medical insurance portion of Medicare, which covers physician services, outpatient hospital care, and many other services typically covered under health insurance plans. Part B is financed through monthly premiums paid by enrollees and by contributions from the federal government. What is the Cost to Enrollees? Premiums In 2017, the standard […]
What Is Medigap or Medicare Supplement Plans A-N?
Medicare Supplemental plans, or Medigap, cover the costs you’re responsible for with Original Medicare. There are 10 Medicare Supplement plan options available; A, B, C, D, F, G, K, L, M, and N. Each plan has different, yet standardized, benefits and coverage that must follow federal and state laws, and must be clearly identified as […]
4 Tips to Help Your Parents Prepare for Medicare
Many people start out learning about Medicare by helping their senior parents find health insurance coverage. Medicare can be confusing at first, and it’s not uncommon to find yourself up to the ears and knee-deep in information about Medicare. But you certainly don’t have to go about it alone. There are a number of great […]
Original Medicare or Medicare Advantage? 4 Questions to Help You Choose
When you become eligible for Medicare, choosing whether you get your Medicare benefits from Original Medicare or Medicare Advantage can be complicated. You may be wondering: “What is the best Medicare plan?” However, there really isn’t a “best” plan – there is only the best plan for your needs. So, how do you decide? First of […]
Does Medicare Pay for Prescription Drugs?
When becoming eligible for Medicare, many Medicare beneficiaries make the mistake of thinking they automatically get prescription drug coverage. This is not the case. Original Medicare (Part A and Part B) does not cover prescription drugs. If you want prescription drug coverage, you must join a plan run by an insurance company or other private company approved […]
Medicare vs. Medicaid: What’s the Difference?
Medicare and Medicaid are both taxpayer funded social government programs established in 1965 that help people pay for healthcare. Despite sounding similar, they are very different programs. Follow along to understand how Medicare and Medicaid work so you can better understand the differences between them. What is the difference between Medicare and Medicaid? The main […]
What Does ‘Medically Necessary’ Mean?
If you are a Medicare beneficiary, you may have come across the term, “medically necessary” to refer to services covered by Medicare. But what does it mean? According to HealthCare.gov, medically necessary services are defined as “health care services or supplies that are needed to diagnose or treat an illness, injury, condition, disease, or its symptoms – […]
Medicare Coverage of Mental Health Services
A person’s mental health refers to their state of psychological, emotional, and social well-being – and it’s important to take care of it at every stage of life, from childhood to late adulthood. Fortunately, Medicare beneficiaries struggling with mental health conditions may be covered for mental health services through Medicare. Mental health services are a […]
Will Medicare Pay for a Lift Chair?
People who need help getting in and out of their chair daily due to life changes such as aging, arthritis, or a recent mobility-limiting surgery, often consider buying a lift chair. However, lift chairs can cost hundreds – or even thousands of dollars, leaving many Medicare beneficiaries wondering if their Medicare health insurance coverage will […]
Does Medicare Cover Assisted Living for Dementia?
When dementia interferes with the daily life of a loved one, many families and caregivers consider an assisted living facility. Assisted living is a type of long-term care (also called custodial care) of services and supports for personal care needs, which include activities of daily living (ADL) like housekeeping, dressing, bathing, meal preparation, eating, medication […]