Becki Explains... Enrolling
The Who What Where When of Enrolling into Medicare.
Medicare Part A covers things like Hospital care, Skilled Nursing Facility care, Home Health care, and Hospice care. Learn more about how each of these is covered, including deductibles and coinsurance.
Becki Explains... Part A Hospitalization
For folks who have a health insurance policy with a daily copay for hospitalization, these plans can help offset those out of pocket costs, whether you choose a daily benefit or a lump sum option. Benefits can be used any way an individual chooses. There is no deductible and no network of hospitals.
Part A Skilled Nursing Facility
Becki Explains... Part A Skilled Nursing Facility
A stay in a Skilled Nursing Facility may be covered by Medicare Part A under certain circumstances. A three day inpatient hospital stay is required before Medicare will pay for your stay in a Skilled Nursing Facility, where meals and skilled nursing care is provided.
Becki Explains... Part A Home Health Care
When skilled home health care services are needed for things like wound care, injections, or monitoring of serious illness, a doctor’s orders are needed to start care. The goal of home health care is treatment, in order for you to regain you independence and get better.
Becki Explains... Part A Hospice
Typically, Hospice Care is provided for folks with a life expectancy of six months or less, if the illness runs it’s expected course. A primary care doctor or hospice doctor must certify that someone is terminally ill. Hospice care can be provided longer under certain circumstances. A hospice team generally consists of doctors, nurses, pharmacists, social workers, counselors and volunteers.
PART B
Becki Explains... Part B coverage
Part B covers things like outpatient surgery, emergency room, doctor office visits, radiology services and physical therapy. Part B has an annual deductible and then pays 80% of the Medicare allowable charge. Part B also covers all of the costs for preventive services like wellness exams, some immunizations and many screenings.
Medigap/Medicare Supplement
Becki Explains... MediGap
Medicare Supplement plans pay once Medicare pays. Medicare allows insurance companies to offer plans designed to offset Medicare deductibles and coinsurance. There are several plan designs to choose from and these plans are purchased from an insurance company.
Becki Explains... Medicare Advantage Plans
Medicare Advantage plans must cover all the services Medicare covers and often include Part D prescription coverage. Plans can choose to cover benefits not covered by Medicare, such as dental, vision, and wellness programs. You must be eligible for Medicare A and B, not have end stage renal disease, and live in the service are where the plan is available.
Becki Explains... Additional Coverage
Understanding additional coverage, what additional coverage is available; and how and when do you sign up for it.
Becki Explains... Appeals and Grievances
How to file an appeal or grievance. If you are concerned about the quality of care you are receiving, you can file a grievance with Medicare for things like long wait times to see the doctor or lack of care. An appeal can be filed with Medicare if you disagree with things like a payment decision.
Becki Explains... Filing A Claim
If you have original Medicare, your provider must file the claim. If you have a Medicare Advantage plan, the provider does not file a claim with Medicare. The claim would be filed with the insurance company.
Learn how much Fraud costs Medicare and how to recognize Fraud, Waste, or Abuse, as well as how to report it.
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