Medicare is the federal health insurance program for people 65 or older, under 65 and disabled for at least two consecutive years, or those who have End Stage Renal Disease (ESRD).
To be eligible to use part A, you must also:
- Be hospitalized for at least three (3) consecutive days
- Be admitted to a Medicare-certified facility with thirty (30) days of discharge from a hospital or other certified facility
- Require further care for the same condition treated in the hospital.
In addition, a doctor must certify that skilled care is required on a daily basis and you must not have exceeded the number of Medicare days you are entitled to.
Part A covers short-term care. Primary services eligible for covereage under Part A include:
- Room and board
- All meals (including special diets)
- Lab and x-rays
- Nursing care
- Pharmacy
- Medical supplies and special equipment
- Oxygen
- Physical, occupational, speech-language, respiratory and air fluidized therapies
How much and how long Medicare pays depends on whether you continue to meet the skilled criteria requirements. Part A pays for 100 percent of all approved services during the first twenty (20) days of a new qualifying facility stay. On day twenty-one (21) through day one hundred (100), you are responsible for a co-payment set each year by Medicare.
Part B, the medical insurance, is voluntary coverage. You pay an annual deductible as well as a monthly premium. Medicare will then pick up eighty (80) percent of the cost of all covered supplies or services while you pay twenty (20) percent.
The most common services eligible for coverage under Part B, in a nursing facility are:
- Physical, occupational and speech-language therapies
- Enteral nutrition and supplies
We take care of billing Medicare for all the eligible services you or your loved one receive. Our business office is always available to help answer any questions you might have about Medicare.