Medicare is an entitlement provided by the federal government. It is for people 65 and older or those earlier disabled, who have kidney failure or long term kidney disease. Medicare is applied for at the Social Security office.
Part A, hospital coverage, is provided without a premium for individuals who themselves or their spouse have worked at least 40 quarters and paid payroll taxes into Social Security and Medicare. For those individuals who have worked less than 30 quarters, the premium is $451 per month. For individuals who have worked between 30-39 quarters the premium is $248 per month.Part B, physician coverage, for most people will cost a monthly premium of $99.90 for 2012. However, if you have Medicare adjusted gross income above $85,000, you will pay a higher premium. If your income is $85,000 or greater, then you will be notified by letter of the amount of your premium.
One of the best benefits of Medicare is the hospital coverage. Part A pays for inpatient hospital stays. Medicare pays for everything for the first 60 days, except for the Part A deductible of $1,156 for 2012. After 60 days you must pay the co-insurance amount. This is $289 per day for days 61-90 and $578 per day for days 91-150. You are on your own after 150 hospital days.
Physician coverage, Part B, pays 80 % and you pay 20%. You also pay the first $140 per year as your deductible.
Medicare pays for certain approved medical treatment. It does not pay for extended nursing home care. Under skilled care Medicare will pay for most of the first 100 days. The first 20 days is paid 100% by Medicare. Day 21 through day 100 you will owe $144.50 per day. Medicare will pay the remainder of the daily charge. Medicare benefits stop after day 100. In order to continue past day 20 the patient must be improving. Medicare does not pay after 100 days. However, it may be possible to apply for and have Medicaid pay for extended nursing home care. You should contact Brent D. Coldiron, (405) 478-5655 if you have questions about Medicaid paying for nursing home care.
Medicare Part C is a special provision under Medicare that offers the alternative of a
Medicare Advantage health plan. This is offered as an alternative to traditional Part A and Part B Medicare by Medicare approved private insurance companies.
Medicare Part D is for prescription drug coverage. This is usually a good idea to subscribe to this extra coverage. This coverage is offered by Medicate approved insurance companies.
For additional information about Medicare you can call 1-800-633-4227.