Medicare Part F is the government's program for people with specific health problems requiring hospitalization. It helps these people pay for their hospitalization with money they receive from the government. Medicare Part F also provides insurance for other family members, such as your spouse or children. It covers various services, including doctor visits, lab tests, and prescription drugs. Medicare Part F is available to people aged 65 or over and is open to those who live in a participating state. Below are parts that Medicare Part F covers.
Inpatient Hospital Services
This part pays for hospital stays. Some benefits include Medications (including chemotherapy drugs), surgery, physical therapy, speech therapy, mental health treatment, and medical equipment like ventilators and wheelchairs. Your amount depends on how long you stay in the hospital and what kind of care you need. For example, if you were hospitalized for at least three days, there might be a deductible and coinsurance. You'll likely need help paying this cost out of pocket until you meet a specific threshold, and the federal government will reimburse you. When this happens, you won't owe anything additional to Medicaid because you already paid enough out-of-pocket. However, if you don't hit your out-of-pocket limit, you can still have to make payments after being reimbursed by Medicare.
Skilled Nursing Facility Services
If you're staying overnight at a skilled nursing facility, you might be able to benefit from Medicare supplement coverage for some expenses. For example, Medicaid could help pay for an extended rehabilitation period if you underwent hip replacement surgery. These costs vary depending on which type of covered service you use. For example, certain benefits may not apply when you enter rehab instead of being treated in a hospital. Be sure to ask about any changes during your visit.
If you qualify for Medicare but don't know where to start, we have licensed insurance agents ready to answer your questions and help you enroll in Medicare Advantage, Medicare Supplement Insurance, and Prescription Part D plans.
Hospice Benefits
People who spend their last months in hospice care may be eligible for Medicare benefits. This includes medication and supplies used to manage symptoms commonly seen near death. Medicaid doesn't usually cover treatments performed in an emergency room, but it's essential to check this option before needing extensive medical assistance. However, be aware that a copayment exists before you can claim these benefits.
Emergency health care services for the first 60 days when traveling outside the U.S.
Emergency medical care isn't typically covered under most plans when you go abroad. Instead, travelers should consider getting extra coverage through MediPass or another plan covering medical needs overseas. Medicare part F covers emergency services and covers this cost when you travel within the United States without supplemental insurance.
Respite Care Benefits
Respite services provide short-term relief for family caregivers. Services can range from home visits to respite care for five consecutive nights. Depending on personal needs and preferences, families often choose a combination of services to best fit their situation. While Medicaid generally won't cover respite care, some plans may offer support. Check with your plan provider to find out more details about which options are available. To qualify, you must need respite care to relieve stress caused by chronic conditions or care for someone with acute illness or injury.
Durable Medical Equipment & Supplies
Durable medical equipment refers to machines intended to reduce pain or assist movement that isn't considered medical devices. Examples include braces for treating foot deformities, walkers, wheelchairs, and scooters. Medicaid typically covers the cost of purchasing durable medical equipment after using other methods to treat the condition without success. Your insurer can explain whether this applies to you. Your insurance company can refuse to pay for certain medical products; check with them if you have questions about coverage.
Long-Term Acute Care Hospital Care
Long-term acute care hospitals provide around-the-clock care for people who require ongoing monitoring and specialized treatment, such as those experiencing complications following heart attacks or strokes. It's difficult to determine whether this type of hospital care should be classified as acute or long-term care because it has both characteristics. For example, Medicaid generally considers patients staying at this facility for more than 30 days to receive acute care. You'll likely pay out of pocket based on your policy provisions during the time spent there. For example, suppose you don't have access to private health insurance. In that case, many states also offer Medicaid programs to help low-income individuals pay for the costs associated with living with illnesses like Alzheimer's, cancer, diabetes, and stroke.
Medical expenses for people who are permanently disabled
If you're incapable of performing everyday tasks due to an accident or disability, Medicaid will cover various medical treatments and supplies needed to keep you alive. Benefits vary depending on the severity of your impairment and how much money your spouse receives in social security benefits. For example, if you or your spouse meets one of the Social Security Administration's criteria for permanent disability, they could get up to $4,100 in monthly cash benefits. That amount increased yearly until 2016, when it reached $2,000 per month. For example, if you meet the requirements and your annual household income was between $50,250 and $62,500 before taxes in 2017, you'd get approximately $11,300 in benefits annually.
If you qualify for Medicare but don't know where to start, we have licensed insurance agents ready to answer your questions and help you enroll in Medicare Advantage, Medicare Supplement Insurance, and Prescription Part D plans.
