PART A RECAP
Good morning all,
I hope life is going well in your world. Today, I wanted to talk about Medicare For All.
It seems that everyone is interested in this topic and I wanted to go over Medicare in-depth. This will hopefully shed some light on those under 65 that are approaching enrollment in Medicare and those well under 65 that are interested in what they can expect under the “Medicare for All” model. This is not a political commentary, because I am not a big fan of either party. The only difference between a Republican and a Democrat is where they get their money from. They are all inept crooks, in my opinion.
End of rant.
This is also not going to go over the costs to us as a country; I am only interested in coverage and cost to the individual on Medicare. Because it is so long I will break it down into five parts over five days. Today will be about Parts A. Monday will be about Part B, Tuesday will cover Part C, Wednesday will cover Part D and Thursday will cover Medigap or Medicare Supplements.
Here is what you can expect when you go on Medicare as it is currently. If they make any changes to Medicare then I will update it as soon as they become available. The following numbers are for 2018.
Part A covers inpatient hospitalization. The monthly premium is $0.00 each month if you or your spouse has worked ten years at a job that has taken out for Medicare. If you do not have the required work credits, 40 quarters or ten years, you can use your spouse’s work history provided you are 65 and your spouse is at least 62 years old. You can use a divorced or deceased spouse’s work history to qualify.
If you do not fall into that category and have 30 to 39 credits or 7.5 years to 9.75 years of work history, you can purchase Part A for $234.00 a month. If you have less than 7.5 years of work history in this country then you will pay $426.00 per month for Part A. You must be a US Citizen or possess a Green Card. You must also have lived in the United States for five continuous years in order to qualify.
As I noted above Part A is the inpatient hospitalization portion of Medicare. If you are admitted into the hospital you will have a $1340.00 deductible. Medicare will pay for a semi-private room unless it is medically necessary that you have a private room. Medicare will cover the costs of the stay except, telephone, television, or a private nurse. Medicare will not pay for incidentals either. Razors, slippers, or toiletries things of that nature are not covered. Medicare will pay for the first 60 days of hospitalization with the exception of the items listed above. If you are in the hospital longer than 60 days but less than 91 days you will have a daily copay of $335.00 per day.
After you have had 90 days of inpatient hospitalization, you will enter the reserve portion of your coverage. Medicare will provide an additional 60 days of reserve coverage but it is not free. If you are in your reserve you will pay the following:
Days 91-150 $670.00 per day.
If you do not have any other type of coverage after day 150, you will pay the entire amount after your 150 days of reserve coverage are used up.
Please keep in mind Medicare does not pay for a nursing home or Home Health Care in most situations so you may want to look into other options should this become available.
Medicare will provide up to 100 days of Skilled Nursing facilities. A Skilled Nursing Facility is a place where you get rehab for an ailment or injury. The facility must be Medicare Accredited in order to qualify.
Medicare will cover the first 20 days of the benefit period at no charge to you. If you need an SNF longer than 20 days, here is what you will have to pay:
First 20 days $0.00
Days 21-100 you will have a co-pay of $167.50 per day.
Days 101 and beyond you will owe the entire amount.
In order for Medicare to cover SNF, you must have a qualifying stay. A qualifying stay is considered three consecutive days in the hospital. You must be admitted into the hospital. Not under observation, which is something doctors are doing more today than in the past. Sometimes it is for Medical reasons but most often it is a monetary decision.
There are certain stipulations for Medicare to cover the stay, too many to list here, but this will give you a basic understanding of Skilled Nursing Facilities.
This is pretty much Part A in a nutshell. I hope this has clarified Part A. Of course, if you have any questions please give me a call or shoot me an email.
As always, do something nice for someone today just because.
Wishing you all the best,
Randall J. Lawson
The HgO Group
National Producer Number #9276045
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