medicare coverage Archives

What are the 4 Types of Medicare – Medicare Coverage

What are 4 types of Medicare? This is a question you may come across when you have to decide what you want covered. In actual sense, they are not types but rather parts of Medicare. Each of them covers a specific area but they are somehow tied to the original Medicare.

What are the 4 Types of Medicare

Health insurance is necessary because it helps relieve the stress when unexpected medical costs occur. When you find yourself in the dark about the Medicare types, this post has the help you need. It will detail the various parts of Medicare and what is covered in each. It will also explore the Original Medicare and tell you when you need it.

Parts of Medicare

Medicare is subdivided into 4 parts as follows;

Part A: It is dedicated to cover inpatient costs or what is called hospital expenses in some quarters. You sign up for Part A when you enroll for Medicare.
Part B: In general, Part B covers medically necessary services, as well as preventive services.
What are the 4 Types of Medicare
Part C: This is an option you can add to Parts A and B to enjoy your Medicare benefits and have additional coverage..
Part D: is for prescription drugs, not Part F which is a separate plan to cover cost sharing with patients.

As you can see, each part/type of Medicare covers a specific area in the health circles. Generally, Part A and B are the most popular types partly because they offer a comprehensive cover for both inpatient and outpatient services. Again, it is because both can be accessed collectively through the original Medicare. Another thing that makes the original Medicare quite popular is the fact that it is under the custodian of the federal government. With it, you can walk into any hospital in the country, receive treatment, and the federal government pays for that service directly.

The Components of the Original Medicare

You can quality for Medicare Part A and B once you are 65, and reach other requirements. In some quarters, original Medicare is referred to as the fee-for-service Medicare. Actually, this is the actual description of how it works. Here are some of the features of the original Medicare as drafted in the act;

You do not require permission or authorization beforehand to go to hospital or see a doctor. You can see a doctor any time and any day without any problem at all and have your expenses covered by Medicare.
You will be paying premiums for part B each month. Some cases also have to pay premiums for Part A. Confirm if you fall into that category before you run into any inconvenience.
For each service you get, you are typically supposed to pay a copay for it.
Hospitals and doctors have a capping to how much they should charge you.

With original Medicare, as you may have already noticed, you are not getting any cover for prescription drugs. You will have to get a separate cover for such from your pocket. Just you know; there are several government-initiated programs that can help you cut down the costs of prescription drugs.

Bottom Line

You should now know the answer to what are the 4 types of Medicare? With this, you can make a decision on what suits your needs. Typically, part A and B come as a package in the traditional Medicare. However, you should make private arrangements for prescribed drugs.

Does Medicare Cover Surgery?

Does Medicare Cover Surgery

The answer is yes – depending on your package. Medicare might cover different parts of the surgery expenses and medical bills.

Medicare Part A will cover the hospital expenses, including the services of nurses, physicians, health providers, and daily services or room cost.

Medicare Part B will cover any medical treatments which are involved in your surgery.

Medicare Part D will cover the prescriptions for your surgery.

To get the coverage for your surgery from the Medicare Part A and Part B, you should meet 2 basic requirements:

The care should be medically necessary. This means that an authorized healthcare provider must authorize the surgery and Medicare should agree that it’s necessary.

A health care provider participating in Medicare should deliver or perform the surgery.

Which Type of Surgery isn’t Covered by Medicare?

Keep in mind that Medicare doesn’t cover any kind of elective surgery. For example, plastic surgery will not be covered if it doesn’t correct an existing medical issue. Also, Medicare won’t cover any treatment which isn’t associated with follow-up care or deemed as medically necessary. Vertex Insurance says that any additional treatments, therapy, or prescriptions which are required as a result of an elective surgery won’t be compensated as well.

How About the Medicare Supplement?

In most cases, if your Medicare covers your surgery cost, your Medicare supplement will cover the remaining part which you’ll typically be responsible for. The coverage amount often depends on your plan letter; for instance, with a Medicare supplement Plan F, you might undergo your surgery without spending any money from your pocket.After you have met your deductible and paid the co-payments, your Medicare would cover 80 percent of the medical bills. With the Medicare supplement, you will be covered for the remaining 20 percent, co-payments, coinsurance, and deductibles from Part A and B.

Estimate the Surgery Costs

It can be a challenging task to estimate the costs for your surgery because a doctor doesn’t know exactly what services you will need. Below are a few things that you can try to have a rough estimation of your surgery expenses:

Ask the employees of the hospital or doctor how much you will need to pay for your surgery and follow-up care.

Find out if you are an outpatient or inpatient because the hospital status can play an important part in your total cost.

Check with your insurance, such as Medicare supplement, to find out what it’ll pay. The covered amount will mostly depend on your plan letters, such as Plan G or Plan F.

Overall, does Medicare cover surgery? It depends on the current Medicare plan you have. Surgery can be an uneasy experience, especially when tackling on all of the expenses associated with surgery. If you currently have Medicare, this information above will help you decipher whether or not Medicare covers surgery expenses.