Medicare is a government insurance health plan, and is the largest
health insurance company in the United States. Currently, 40 million
Americans participate in Medicare health insurance services. The
Medicare insurance plan has 4 parts that offer unique coverage to
individuals who qualify. To receive coverage, participants must meet
certain requirements, such as U.S. citizenship. Individuals must meet an
age requirement of 65 years or older, or less than 65 years old with
certain disabilities.
Most people do not have to pay a premium for Part A if they or their
spouse paid Medicare taxes while working. If this is not the case,
individuals can buy Part A coverage if certain requirements are met. If
individuals want to buy Part A, in most cases, they are also required to
buy Part B.
Medicare Part A covers inpatient hospital stays. This includes
semi-private rooms, meals, nursing, and other hospital supplies and
services. Private-room nursing, televisions, and telephones are not
included if the hospital charges extra for these amenities. Personal
care items are not covered. Individuals must stay in the hospital at
least 72 hours to receive coverage.
Home health services are also covered under Part A. Individuals must be
homebound to qualify, which means they should find it difficult to leave
their homes. A doctor has to order home health services. The plan
covers skilled nursing care, physical therapy, speech-language
pathology, and continual occupational therapy. Medicare-certified home
health agencies must provide the care. They can also provide medical
supplies for home use, medical equipment, and home aid services.
Hospice care is provided for people who are terminally ill. A doctor
must inform Medicare that an individual is expected to live 6 months or
less. Hospices that are certified by Medicare can give hospice care at a
person’s home or a qualified facility. Coverage includes medication for
pain relief, medical, nursing, and social services. Grief counseling is
not covered.
Respite care is also covered under Medicare Part A. An individuals can
receive care from Medicare-approved facilities so their caregiver can
have time to rest. A person is allowed to stay up to 5 days per respite
care visit. Other health problems that are not related to the patient’s
terminal illness are covered as well.
Medical care in a skilled nursing facility is also covered. This
includes rehabilitation administered by certified skilled nurses,
semi-private rooms, and meals. These services are only covered with a
minimum of 72 hours of inpatient stay. Doctors must declare that
individuals need skilled daily care in order to qualify. Long-term or
custodial care is not covered in a skilled nursing facility.
The blood that is used in blood transfusions is also covered under
Medicare Part A. The hospital gets its blood from blood banks free of
charge. If for some reason the hospital has to buy blood for you, you
will have to either pay the hospital costs or have the blood donated.
