Today we present the first part of a three-part series on Medicare. It will run on Mondays.

HE SAYS:

We all realize that as we age not only does the risk of illness increase; but, also, we must face the prospect of increasing health care expenses.   With this in mind, the Federal Government created the Medicare Program in an effort to help with the health care expenses we will all face as we grow older.

Medicare, Part A, also known as the Original Medicare Plan or “fee-for-service”, is automatically available to you, without cost, when you turn 65 years old if you or your spouse worked and paid Medicare taxes.   If you or your spouse did not pay Medicare taxes while working, you still may be able to buy Part A coverage when you turn 65 years old.

Medicare, Part A, helps pay for care in hospitals as an inpatient, critical access hospitals, skilled nursing facilities, hospice care, and some home health care.  You may go to any hospital that accepts Medicare and a fee is charged each time you receive a service.   Medicare pays its portion of the fee and you pay the balance of the fee.

Medicare, Part A, helps pay for hospital stays in a semi-private room and includes, general nursing and other hospital services and supplies.  It does not cover private duty nursing, telephone or television expenses or a private room, unless medically necessary.

The portion paid by Medicare, Part A, is measured by a Benefit Period which begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any facility for 60 days in a row.  

The portion not paid by Medicare, Part A, is paid by you as a deductible.   The Medicare, Part A, deductibles for 2011 are as follows:

1.  Hospitalizations:  During any Benefit Period, you pay $1,132.00 for the first 60 days; $283.00 per day for the 61st through 90th day; $566.00 per day for the 91st through 150th day; and all of the expenses after the 150th day.

2.  Skilled Nursing Facility Care: During any Benefit Period, you pay none of the approved expenses for the first 20 days; $141.50 per day for the 21st through 100th day; and all of the expenses after the 100th day.   You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare approved facility within thirty days after leaving the hospital.

3.  Hospice Care:   As long as your doctor certifies that you are terminally ill and you elect to receive these services, you pay none of the approved expenses, except for a very limited co-insurance for outpatient drugs and inpatient respite care.

As you can see, even though helpful, Medicare, Part A, still leaves you with potentially devastating health care costs if you are ill and hospitalized for any length of time.

In the next installment we will outline the benefits of Medicare, Part B.

WHAT DO YOU SAY?