Medicare Benefits

Medicare characteristics

-Almost everyone age 65 and older is eligible for Part A benefits. -If a person is receiving monthly Social Security or railroad retirement benefits, the person is automatically covered under Part A. -People who are eligible for Medicare but are still working must be given an option to participate in their employer's group insurance. -People who are eligible for Part A coverage are automatically enrolled in Part B coverage. If Part B is not wanted persons may opt out.

Medicare is comprised of three parts:

-Part A, which covers hospital care, skilled nursing care, hospice care, and home health care, -Part B, which is optional and covers physicians' fees and outpatient services, -Part D, prescription drug coverage.

Part B Benefits - continued

-Part B pays 100% of X-ray and pathology services -Premiums are scaled based on income. -When a worker is first enrolled in Part B at age 65, there is a six-month open enrollment period in Medigap. If the open enrollment period has expired, the applicant may be denied a policy based on health status or may be charged higher rates.

Part B benefits:

-There is a $183 deductible that the insured must pay, and then all covered services are paid at 80% with the insured responsible for the other 20%. -Covered expenses include physician's services, home health services not requiring a hospital stay, diagnostic tests, medical equipment, and all outpatient services of a hospital.

Part A benefits:Skilled nursing home benefits

-are limited to 100 days per benefit period. All expenses are paid for the first 20 days. The patient co-pay is $164.50 a day for the 21st to 100th day of each benefit period for 2017.

Part A benefits:Home health care

-is limited to 21 consecutive days per illness, and no hospital stay

Part A benefits:Hospital care benefits

-provide coverage for the costs of a hospital stay in excess of the deductible which is $1,316 for the first 60 days in the hospital. -From days 61 - 90, the patient has a co-pay of $329 per day. -After 91 days, a lifetime reserve of up to 60 days is available, the patient co-pay for the lifetime reserve is $658 per day. These amounts apply to 2017.

Part A benefits: Hospice Care

Hospice care, unless recertified as terminal, is limited to 210 days.