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There are four parts of Medicare. In general:
Medicare Part A covers:
Medicare Part B covers:
Durable medical equipment: Equipment that serves a medical purpose, able to withstand repeated use, and appropriate for home use, is covered.
Home health services: If you are homebound and need skilled nursing or therapy care, you’re covered under Part B.
Ambulance services: Emergency transportation by ambulance. Limited coverage for non-emergency transportation is available in which there is no safe alternative as long as it is medically necessary.
Preventative services: Outpatient physical, speech, and occupational therapy services are covered as long as they are administered by a Medicare-certified therapist.
X-rays and lab tests: All doctor ordered x-rays and lab tests are covered.
Chiropractic care: Only when medically necessary to fix subluxation of the spine.
Medicare Part C, also known as Medicare Advantage, is a private health plan provided by insurance companies contracted with the federal government.
You will still be enrolled in Original Medicare (Part A and B), however Medicare Advantage plans may offer certain benefits that Original Medicare doesn’t cover, such as:
Part D is prescription drug coverage. This covers most outpatient prescription drugs.
Part D is offered through private insurance companies as either a stand-alone plan or as a set of benefits included with a Medicare Advantage Plan.
Each Part D plan has a list of covered drugs called a formulary. If the drug you need is not on the formulary, you are allowed to request an exception, pay out of pocket, or file an appeal.
These formularies differ from plan to plan so be sure to request a copy. However, each plan must cover all drugs in the following categories:
Most vaccines are also covered under Part D unless they are already covered under Part B.
Medicare Part D has four phases of coverage:
Deductible, Initial Coverage Phase, Coverage Gap or Donut Hole, and the Catastrophic Phase.
The Medicare 8-minute rule applies to outpatient rehabilitation services such as physical therapy. This rule helps providers determine who many billable units of time they
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The Medicare 8-minute rule applies to outpatient rehabilitation services such as physical therapy. This rule helps providers determine who many billable units of time they
The costs of any given Medigap Plan G will vary widely depending on a variety of factors. The most important of these factors will be
No one wants to pay more than they have to for any part of their Medicare coverage. We hate when we see our clients get
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