What Does Medicare Insurance Cover?

Posted on 05/02/2013     What Does Medicare Health Insurance Cover? When a person becomes Medicare eligible, Medicare becomes their health insurance.  It is not required to purchase any additional coverage.  When that Medicare beneficiary seeks medical care, such as a doctor visit, lab work, or a hospital stay, she shows her red white and blue Medicare card, and that is it. Medicare will pay for the majority of these bills, and the patient is responsible for a portion of those costs as well. Some of the items that the Medicare Beneficiary is responsible for:
  • Hospital Stay-Per Admission deductible of $1,184
  • Hospital Stay 61-90 Days- Per Day copay $296
  • Hospital Stay 91-150 Days- Per Day copay $592
  • Medical (Part B) Annual Deductible of $147
  • Medical (Part B) Co-Insurance of 20% for all Medical Part B expenses, such as dr visits, outpatient surgery, diagnostic, lab, physical therapy, etc.
  • Prescriptions are not covered by original Medicare
As you can see, there are many “gaps” in Medicare, where the Medicare beneficiary is responsible for potentially large outlays.  For this reason, the great majority of seniors purchase some type of additional Medicare Insurance to supplement Medicare.  Medicare remains the person’s primary insurance, and the Medicare Supplement plan (also known as Medigap) merely pays for all or most of the above mentioned costs that the beneficiary would otherwise have to pay. The Three Most Popular Medicare Supplement Plans- Plan F,  Plan G & Plan N When a Medicare beneficiary purchases a Medicare Supplement Plan, Medicare remains his primary insurance, and the Medicare Supplement Plan will pay for most or all of the deductibles, copays and co-insurance that he would normally have to pay.  Medicare Supplement Plan F is the richest plan.  With Plan F, the senior is not responsible for any out of pocket costs- the Medicare Supplement plan pays for everything.  For example, for a hospital stay, dr. visits, and lab work, the patient pays nothing. This can all be confusing.  we are here to help! Just call (215) 658-1776 and we will assist you any way possible.

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