What Does Medicare Cover?

(Note: All Dollar Amounts Are Based On 2002 Figures.)

Medicare is packaged in two parts: Part A and Part B. Qualified individuals automatically receive "Part A" which is hospitalization insurance. When all coverage requirements are met, Part A of Medicare will help pay for limited hospitalization coverage, limited post-hospital skilled nursing home care, home health care, limited hospice care and blood, after the first three pints

How Much Does Part A Pay For Skilled Nursing Care?

It will pay for the first 20 days if you go directly from the hospital to the skilled nursing care facility. It will pay $101.50 per day for the 21st through the 100th day per benefit period.

How Much Does Part A Pay For Inpatient Hospital Care?

During a benefit period, Medicare Part A will help pay for the first 90 days of medically necessary care in a Medicare-certified hospital. During the first 60 days, Medicare will pay all covered costs except the deductible. During a benefit period, you pay the deductible only once, regardless of the number of times you go to the hospital. However, during the 61st through the 90th day, Medicare pays all covered costs except for coinsurance of $203 per day. You are responsible for paying the coinsurance.

What Is A Reserve Day?

If you are in the hospital for more than 90 days in a benefit period, you can use your reserve days to help pay the bill. If a reserve day is used, Medicare will pay all covered cost except $406 per day. You are responsible for the coinsurance.

Under Part A, Which Hospital Services Are Covered?

However, Part A will not pay for expenses which are care-related such as telephone, television, private duty nurses or the amount between a semiprivate and private room rate unless it is medically necessary

What About Filing A Claim and Handling Deductibles?

The best news yet is that you do not have to file a claim for payment. The facility from which you received care will file the claim for you. However there is a deductible which is an amount that you pay before Medicare pays anything. As of January 1, 2002, the deductible per benefit period is $812.

What Does Medicare Part B Cover?

Medicare Part B is medical insurance rather than hospital insurance. It helps to pay for:

Article Revised 03/02


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