Medicare Eligibility
The following groups are eligible for Original Medicare (both Part A and B)
- In general if you are senior and meet criteria for certain disabilities.
- A U.S. citizen or if you have been a Permanent Resident of the U.S. for the past 5 years.
- Even if you are already receiving Social Security benefits, you need to be a senior to get Medicare.
- You are a senior (Your spouse's age does not apply).
- You can still be eligible for Medicare when a senior even if you are not receiving Social Security benefits.
Medicare Benefits
Here's a brief look at what Medicare Part A and Part B cover
Part A
most medically necessary hospital, skilled nursing facility, home health and hospice care.
- Inpatient hospital care
- Psychiatric hospital care
- Home health care
- Skilled nursing facility care
- Blood transfusion during your hospital stay
Part B
most medically necessary doctor's services, preventive care and other medical service not requiring hospital stay.
- Doctors' services
- Outpatient medical & surgical services
- Ambulance services
- Outpatient mental health care.
- Laboratory services
- Durable medical equipments(Wheelchairs, Home oxygen supplies, etc...)*
- Outpatient physical, occupational, speech-language therapies
- Certain Preventive care services
You must be entitled to Medicare Part A and enrolled in Medicare Part B and live in the plan's service area to be eligible for these plans. You must continue to pay your Medicare Part B premium.
Medicare Resources
Centers for Medicare and Medicaid Services
Part A
Costs- Most people don't pay a monthly premium
- Member pay $1,364 deductible for each benefit period. Days 1-60: $0 coinsurance for each benefit period.
- Enrollment is simple. You cannot be denied coverage because of current or past health problems.
- You may have to pay more for long term hospital stay.
- Hospital inpatient stay longer than 60 days requires co-insurance per day of each benefit period.
- You may need to pay separate co-insurance for each hospital stay.
- Original Medicare allows you to go to any hospital that accepts Medicare.
- In general, health care you get in a foreign hospital isn't covered.
Part B
Costs- There is no yearly limit for what you pay out-of-pocket.
- In general, after your deductable, you pay 20% of the Medicare-approved amount of the service
- You may have to pay a late enrollment penalty if you don't sign up for Part B when you are first eligble.
- Enrollment is simple. You cannot be denied coverage because of current or past health problems.
- Part B offers the same benefits throughout the U.S. The services you receive are not limited to a particular state or region
- However, in general, Part B does not cover medical services you receive outside the U.S.
- You can see any provider who is participating in Medicare and who is accepting new Medicare patients.
- There are limits on certain preventive care services.