Medicare

Today we at Federal National Funding would like to provide introductory information about Medicare.

Medicare, not to be confused with Medicaid, is a government health care insurance program for the elderly as well as certain disabled people. This program has four basic parts: A, B, C, and D. Part A provides basic coverage for hospital care as well as limited skilled nursing care (up to 100 days), home health care, and hospice care. Part B can assist can with covering physician services, inpatient and outpatient medical services and diagnostic tests. Lastly, part D covers prescription drugs.

There’s also Medicare Advantage; this is a type of private insurance that includes Medicare-approved HMOs, PPOs, fee-for-service plans and special needs plans. Some of these plans offer prescription drug coverage. In order to join Medicare Advantage plan, you need to have Medicare Part and Part B, pay the monthly premium for Medicare Part B to Medicare and the Medicaid Advantage premium.

Costs

Every time you go to the hospital you would have to pay for a part of your hospitalization costs, unless your visits are separated by less than 60 days. If that is the case, you would only have to pay the deductible the first time. Now if you were to stay in the hospital longer than 60 days you would have to pay a copayment every day from day 61 to 90.

Skilled Nursing Care

Medicare will pay for the first 20 days of skilled nursing care, but only after you’ve been in the hospital for three days. This means you’ll have paid at least the deductible for that three-day stay. From the 21st day through the 100th day, Medicare will cover some of the costs of skilled nursing care, but you still have a copayment. After 100 days, Medicare will not pay for skilled nursing care, and you must bear the full cost. The 100 days are per benefit period.

Medigap

To put it simply, Medigap is Medicare supplemental insurance that is made to cover the costs Medicare does not. Usually, it pays for the deductibles and copayments required by Medicare. Please note that coverage will vary according to individual policies.

Medigap insurance may not pay for any additional procedures that aren’t specifically addressed by Medicare. Most policies will only help to cover the deductibles and copayments imposed by Medicare.

Long Term Care

Be aware that Medicare only provides limited coverage for skilled nursing care and only pays for up to 100 days of care following a three-day hospital stay. Medigap will not fill in the gaps for this coverage.

For more information regarding Medicare or Medigap, please call our office at 201-342-3300 or click here. To learn more about us at Federal National Funding, feel free to call our office or click here.