Medicare is the federal health insurance program for people who are age 65 or older. Almost all seniors are enrolled in Medicare, which pays for outpatient visits, hospital stays, prescription drugs, and much more. There are four different parts of Medicare, and each part covers a different aspect of health care.

When to Enroll

Once you are eligible, you have seven months to enroll in Medicare (called the “Enrollment Period”) before you have to pay a late enrollment fee. Because most people pay into Medicare when they work, they won’t have to pay a premium for Medicare Part A. – even if they have health insurance through their employer. Although everyone pays a monthly premium for Part B, it varies based on income. That standard premium for 2017 is $134.

What Does Medicare Cover?

There are four separate parts to Medicaid, and each one covers a different aspect of medical care. Most people are enrolled in Part A and Part B, but it is important to learn about all four parts of Medicare to determine which coverage you might need.

Part A – Hospital Insurance

Medicare Part A covers inpatient hospital stays (including emergency room visits), care in a skilled nursing facility, hospice care, and some home health care. However, Part A will not cover care in a skilled nursing facility for a long-term resident.

If you or a loved one needs long-term care in a nursing home or assisted living facility, you may want to consider Medicaid instead. Medicaid is a federal needs-based program administered by the states that provides coverage for people who need long-term care.

Part B – Medical Insurance

Medicare Part B covers outpatient care, medical supplies, and some doctors’ services.

Part C – Medicare Advantage Plans

Medicare Part C is the least-used type of Medicare coverage. It is a type of health plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits. If you have Medicare Part C, often called a Medicare Advantage Plan, most Medicare services are covered through the plan instead of Medicare Parts A and B. Most Medicare Advantage Plans offer prescription drug coverage.

Part D – Prescription Drug Coverage

Medicare Part D adds prescription drug coverage to Medicare Parts A and B, and is offered through private insurance companies.

Do I Need a Medicare Attorney?

Medicare Denials

If you are denied Medicare coverage, what seems like a simple application process can be confusing. Navigating the maze of appealing that decision and reapplying for benefits can be stressful. An experienced elder law attorney can serve as an advocate for you, increasing your chances of being approved for benefits.

Medicare Fraud

On the other hand, if you are accused of obtaining Medicare benefits under false circumstances (called Medicare fraud), you could face fines or even jail time. An attorney can help defend you against these claims and reach an ideal conclusion for your circumstances.

If you would like to learn more about Medicare or if you need the assistance of an attorney to help you navigate the Medicare process, contact Alperin Law today to schedule your consultation.

Scott Alperin
Experienced Estate Planning & Elder Law Attorney Serving Virginia Beach Area Clients Since 1994.
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Isaac smith 12/28/2020 05:05 PM
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W M 03/21/2022 09:00 PM
The whole Medicare application process is a minefield of unpublished rules designed to rip you off. Some gotchas: - The deadline for applying for Part B is a month earlier than your birth month, **if your birthday is on the first day if the month**! - Medicare begins billing you for Part B *based on the month you start filling in the online app*, not on the month you actually file it. So you pay $hundreds$ for coverage you don't need. - Income surcharges for Part B are based on your income *two year before you apply*, possibly even before you retired. To add insult to injury, hold times to talk to an agent can be well over an hour. Beware!!
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