Law For Older Adults‎ > ‎Public Benefits‎ > ‎Medicare‎ > ‎

Coverage

Medicare Part A
Covers hospitalization and certain limited coverage in skilled nursing facilities
  • first 100 days of home care and hospice benefits for the terminally ill-Medicare Co-Payment—Skilled Nursing Facility
  • pays the first 20 days in full, but for days 21 to 100, the Medicare recipient pays a co-payment and Medicare pays the balance-Deductible
  • hospital coverage is limited to ninety days per spell of illness
    • For sixty days there is a deductible that is adjusted annually.Co-Insurance
    • For the next 30 days of hospitalization, the patient pays co-insurance of 25 percent of the deductible
    • For days 91 to 150 per spell of illness, utilizing “lifetime reserve days,” there is a co-payment of one half of the deductible

Medicare Part B
Covers physicians, diagnostic tests, medical equipment, ambulance services, outpatient physical and speech therapist, certain home care, and prostheses
  • persons over 65 years of age or eligible for Part A and who are receiving SSDI after two years
  • Deductions for services covered by Medicare Part B- adjusted annually.
Eligibility Drug Benefits
  • beneficiaries pay premiums depending on their income
  • premiums are adjusted annuallyMedicare Part D
  • individuals must be eligible for either Part A or Part B of Medicare
  • prescription coverage either through a stand-alone prescription drug plan (PDP) or through a Medicare Advantage Plan (MA-PD)