Medicare Part A
Medicare Part A only pays for a total (lifetime limit) of
190 days of inpatient care in a Medicare certified psychiatric facility
Medicare Part A hospital and skilled nursing facility benefits are paid on the basis of
Benefit Periods
Short-term inpatient care is
Covered services for Hospice Care
Medicare covers home health services for
as long as needed
Medicare will cover all
but the first 3 pints of blood
Although Medicare does not cover prescription drugs as part of
Home health care
People of all ages who are terminally ill can get
Hospice care
If doctor decides medical care at home is needed, and makes a plan for care at home; only then
Medicare will cover health care
Skilled care is health care given when the patient needs skilled a nursing or rehabilitation staff to manage, observe, and evaluate care, when given in a
Medicare-certified SNF
If the beneficiary does not have medicare part A then will he be covered by SNF
NO
the patient's cost in Original Medicare for home health care services is
$0
The coinsurance rate for days 21 through 100 in a skilled nursing facility is
$176
For days 61 through 90 of hospitalization in a benefit period, Medicare Part A will pay all covered expenses after the patient pays a daily copayment amount that changes annually. Beneficiaries must pay an additional
$352
Medicare pays all cost for days
1 through 20 days
Medicare covers certain skilled care services that are needed daily on a short-term basis up to
100 days
the patient's cost in Original Medicare for durable medical equipment is
20%
Medicare does NOT cover
24-hour-a-day care at home; Meals delivered to a home; Homemaker services like shopping, cleaning and laundry; or Personal care given by home health aides like bathing, dressing, and using the bathroom when this is the only care needed
What are the qualifying days to be in a hospital to cover the SNF
3 consecutive days
The benefit period ends when the patient has not been in a SNF or a hospital for at least
30 days
The patient must enter the SNF (Skilled Nursing Facility) within
30 days
The patient can get hospice care as long as the doctor and the hospice medical director or other hospice doctor certifies that the patient is terminally ill and probably has
6 months or less to live
Medicare will pay all charges for covered hospital services during the first
60 days of a benefit period except for a deductible
Medicare defines part-time or intermittent as skilled nursing or home health aide services combined to total less than
8 hrs per day and 28 or fewer hrs each week. Based on the need for care, on a case-by-case basis, the weekly total may be increased up to 35 hours
The Medicare Summary Notice is also referred to as an
Explanation of Medicare Benefits (EOMB or EOB)
Hospice care is available under Medicare only if the patient meets the following requirements:
Is eligible for Medicare Hospital Insurance (Part A); Signs a statement choosing hospice care instead of standard Medicare benefits for the terminal illness; Receives care from a Medicare-approved hospice program; and The patient's doctor and the hospice medical director certify that the patient is terminally ill with 6 months or less to live if the disease runs its expected course
Medicare Part A providers are required to file a claim with a
Medicare Intermediary
The patient is responsible only for the following
No more than $5 for each prescription drug and other similar products. The hospice can charge up to $5 for each prescription, outpatient drugs, or other similar products for pain relief and symptom control. 5% of the Medicare payment amount for inpatient respite care
Patients who get health care from a Medicare Advantage Plan must get at least the same coverage as the
Original Medicare Plan
changing sterile dressings, intravenous injections and physical therapy are examples of
Skilled Care
Semi-private room; Meals; Skilled nursing care; Physical therapy*; Occupational therapy*; Speech-language therapy*; Medical social services; Medications; Medical supplies and equipment used in the facility;
Skilled Nursing Facility
Home Health Care is
Skilled care is skilled nursing care and certain other health care services the patient receives at home for treatment of an illness or injury
getting in and out of bed, eating, dressing, and using the bathroom are the examples of
custodial care
Medicare does not cover
custodial care, if that is the only kind of care needed
If the patient lives longer than 6 months, the patient can still get hospice care, as long as the hospice medical director or other hospice
doctor recertifies
The patient pays for the
first 3 pints of blood
What are the lifetime reserve days in Medicare
from days 91 to 150 days
Families of people who are terminally ill may also benefit from
hospice care and can receive counseling services
Hospice care for people who are terminally ill includes
physical, psychological, social, and counseling services
s. In 2006, a prescription drug benefit was added to Medicare that pays some, but not all
prescription drug costs under home health care
Inpatient hospital care does NOT include
private-duty nursing, a phone or a television in the patient's room, or personal care items, such as razors or clipper socks
Medicare covered hospital services
include a semiprivate room, meals, general nursing, drugs as part of inpatient treatment, and other hospital services and supplies
Medicare Part A, days 1 to 60 are
inexhaustible
Respite care
is care given to a hospice patient by another caregiver so that the usual caregiver can rest
Rehabilitation care is used to help improve a condition within a given time period, or set up a
maintenance program
Medicare covers inpatient
mental health care services
First-dollar coverage means there is
no deductible
Is private room covered by Medicare
no, only in special circumstances
the skilled nursing care and home health aide services are only covered on a
part time or intermittent basis
Medicare pays all cost for
r home health care visits
Registered nurses, Licensed Physician, Physical therapist, speech-pathology and audiologist are under
skilled care
Hospice is a special way of caring for people who are
terminally ill
Ambulance transportation will be covered
unless arranged by the hospice medical team
Care in an emergency room or an inpatient facility will be covered
unless arranged by the hospice medical team
The patient is homebound,
which means the patient is normally unable to leave home or that leaving home is a major effort. When the patient leaves home, it is only for a short time and not very frequently (for example, to attend religious services or to get medical treatment
If Billy went to hospital and on July 1st 2020 and left hospital on July 15th 2020, and re-entered the hospital for same reason on Aug 1st 2020, will he be covered and how many times he has to Part A deductible.
yes, one time $1408