Part A

Medicare Part A (Hospital Insurance) helps cover your inpatient care in the following facilities:

• Acute Hospitals

• Critical Access Hospitals (CAHs)

• Long Term Care Hospitals (LTCHs)

• Religious Non-Medical Health Care

• Rehabilitation Hospitals

• Psychiatric Hospitals

• Skilled Nursing Facilities (SNFs) (not custodial or long term care)

It also helps cover hospice care and some home health care associated with a qualifying inpatient hospital stay, however, you must meet certain conditions. A person who is entitled to Social Security monthly benefits or is a qualified railroad retirement beneficiary is automatically entitled to Medicare Part A beginning with the first day of the month in which the individual attains age 65.

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Part B

Medicare Part B is a voluntary program that pays all or part of the costs for physician services, laboratory services, ambulance services, durable medical equipment, prosthetics, orthotics, medical supplies, outpatient hospital services, certain home health services, services furnished by rural health clinics, ambulatory surgical centers, comprehensive outpatient rehabilitation facilities, and certain medical and other health services not covered by Part A of Medicare.

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Durable Medical Equipment (DME)

 

Medicare Part B (Medical Insurance) covers durable medical equipment (DME) that your doctor prescribes for use in your home.

 

 

In certain circumstances, the DME that Medicare covers includes, but isn't limited to:

·         Air-fluidized beds

·         Blood sugar monitors and diabetic testing strips

·         Canes (however, white canes for the blind aren't covered)

·         Commode chairs

·         Crutches

·         Home oxygen equipment and supplies

·         Hospital beds

·         Infusion pumps (and some medicines used in infusion pumps if considered reasonable and necessary)

·         Nebulizers (and some medicines used in nebulizers if considered reasonable and necessary)

·         Patient lifts

·         Suction pumps

·         Traction equipment

·         Walkers

·         Wheelchairs

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Home Health & Hospice

Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) helps pay for eligible home health services that are medically necessary. A doctor must certify that the patient is homebound and in need of skilled nursing care on an intermittent basis, physical therapy, speech language pathology, or a continuing need for occupational therapy.

Medicare Part A entitlement is necessary in order to receive coverage for hospice benefits. When a Medicare beneficiary’s physician certifies a six month life expectancy, the Medicare beneficiary can decide to waive Original Medicare coverage for their terminal illness. Pre-election counseling furnished by a medical director or other employee of a hospice agency can assist Medicare beneficiaries considering hospice who have a prognosis of a six month life expectancy. Hospice assists Medicare beneficiaries with such services as nursing care, medical supplies, drugs for symptom management and pain, inpatient and respite care, home health aide and homemaker services, therapy services, medical social services and dietary and other counseling. Medicare beneficiaries can terminate hospice coverage and return to Original Medicare by signing a revocation letter.