Medicare - What is it?

Medicare is a health insurance program regulated by the federal government that is made up of two parts, Part A and Part B.

Part A of Medicare automatic for people over the age of 65 that may receive Social Security. Medicare Part A can be joined if you pay a premium. Part A covers hospital visits up to 90 days. There may be a lag in benefit payments.

Benefits are paid to the hospital directly. 61st to 90th day of treatment has an additional deductible. Part A also includes prescription drugs (while in the hospital.) Skilled nursing and hospice may be covered, but not always.

Part B only covers charges for physicians, surgeons, and other health services. Part B does not cover eye and hearing exams, foot care, immunizations, or physical exams.

Services Not Covered by Medicare

• Custodial care, such as help walking, getting in and out of bed, dressing, bathing, toileting, shopping, eating, and taking medicine (these are commonly referred to as activities of daily living)
• More than 100 days of skilled nursing facility care during a benefit period following a hospital stay (the Medicare Part A benefit period begins the first day you receive a Medicare-covered service and ends when you have been out of the hospital or a skilled nursing facility for 60 consecutive days)
• Private duty nursing care
• Most outpatient prescription drugs, although a Medicare-endorsed prescription drug discount card will be available sometime in 2004
• Homemaker services
• Most dental care and dentures
• Health care received while traveling outside the United States, except under limited circumstances
• Cosmetic surgery and routine foot care
• Routine eye care, eyeglasses (except after cataract surgery), and hearing aids.

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