Insurance and Prescription Drug Coverage
- Part A covers in-patient hospital stays, short-term care in skilled nursing facilities, hospice care, and some home health care. Part A is free if a person has paid into the Social Security trust fund for 40 quarters, or 10 years
- Part B covers outpatient hospital care, doctor’s visits, laboratory fees, durable medical equipment, and some preventive care like mammograms. There is a monthly fee for Part B, called a premium
- Both Part A and Part B have co-payments and deductibles which are the patient’s responsibility to pay. A deductible is the amount the patient pays at the start of each year, before Medicare provides coverage. A co-payment is the amount left for the patient to pay after Medicare pays for a service
Long-Term Care Insurance
- Medicare does not cover most long-term care, whether in a nursing home, assisted living, an adult day care center, or in your own home. Private long-term care insurance companies provide coverage to help pay for these services
- Long-term care policies can differ in important ways. Not everyone should buy long-term care insurance
Medigap (Supplemental Medicare Insurance)
- Medigap insurance fills some of the gaps in Medicare coverage, paying for some health care costs that Medicare does not pay. The more gaps that a Medigap plan covers, the more expensive the policy is to buy
- Eligibility for Medigap policies can vary. Plans must offer “guaranteed enrollment” for new Medicare beneficiaries who are turning sixty-five years of age: the plan cannot refuse to enroll a beneficiary, even if he or she is injured or sick.
Prescription Drug Coverage
- Part D prescription drug coverage is provided by private insurance companies, subsidized by Medicare. Coverage ranges from basic to extensive and from low-cost to more expensive.