What Does Medicare Cover?

What Does Medicare Cover? (1)

Tuesday, 14 June 2016 23:41

What Does Medicare Cover?

Written by

What Does Medicare Cover?

 

What is Medicare?  What does Medicare cover?

I can’t possibly tell you everything you want to know about Medicare, or all of the options.  What I can do is provide a bit of a birds-eye view or summary about some of the pertinent parts of Medicare and how it relates to estate planning and long-term care.

 

The program is available to most people over 65 years old.  Medicare covers medical expenses, hospital care, and post-hospital care.  It also provides some coverage for prescription drugs under “Part D”.

 

Medical expenses:

Medicare covers 80 percent of approved qualified medical expenses and includes things like doctors and surgical services.

 

Hospital Care:

Hospitalization is covered for 90 days per “spell of illness” with a deductible for the first 60 days, and a co-payment of $315 per day for the remaining 30 days.

 

Post-hospital skilled nursing home care:

If the hospital stay is at least 3 days, and only of the post-hospital care needed is “skilled care”, Medicare will cover 100% of the costs for the first 20 days, and a co-pay of $157.50 per day for the next 80 days for a maximum of 100 days of care.  Availability is very limited. 

 

Does Medicare Cover Long-Term Care?

No, Medicare does not cover long-term care.  As described above, Medicare only provides some home care and it must be under very specific situations. 

 

Other Medicare aspects include (but are not limited to):

  • There are “gaps”, and private policies can be purchased to fill these gaps.  These are “Medigap” plans. 
  • Medicare doesn’t cover hospital costs beyond 150 days
  • Medicare doesn’t cover skilled nursing home costs beyond 100 days
  • Medicare doesn’t cover ANY custodial nursing home care or non-skilled home health care

 

Medicare Part D

Medicare Part D is an optional prescription drug coverage.  It is automatic in certain situations for certain people on Medicaid and others.  There are some co-pay rules and many twists and turns that I won’t get into here.   The enrolment period is 3 months prior to, and up to 3 months after your 65th birthday.  A person can only change their plan once a year.  There are also many different plans from which to choose that I won’t get into in this (or likely any) blog.  I simply wanted to provide a general background into Medicare.

 

Please feel free to give me a call today and we can review your situation and other Estate Planning goals.  Everyone’s situation is different, and I can help create solutions. 

 

See lots of estate planning information on my website at: www.myestate-plan.com

 

William Daniel Powell (Dan)

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

****************

This document is for informational purposes only.  Nothing in this is to be considered legal advice.  Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship.  If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction.  I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

****************

Latest blog posts

Blog Categories