An Overview of Medicare Part A and B

I have BlueCross HMO through my job. I will be 65 in June and will have parts A and B of Medicare.  How do these 2 insurances work together?

Answer:

Medicare Part A generally covers you for in-patient hospital care in a semi-private room. In particular, it covers inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (but not if it is custodial or long-term care). It won't include such amenities as a telephone or tv in your room.

Medicare Part A will provide some coverage for hospice care, and may also provide coverage for some home health care, but you'll have to expect some payment on your part. I presume that, because you've been working, that you'll have part A coverage without any premium.

Part B is different. This insurance is designed to help cover the cost of doctors' services and other outpatient care. It fills some of the gaps of Part A coverage, such as some of the services of physical and occupational therapists (which can occur in a hospital setting), and some home health care that isn't covered by Part A. Keep in mind that Part B will only pay for these services and some medical supplies when they are considered medically necessary -- so they must be prescribed by a doctor.

You are smart to have Part B coverage already. The longer you wait to get Part B after you become eligible, the more expensive your premium will be for this coverage.

Unlike Part A, Part B will cover some preventative care, in addition to urgent care.

Medicare doesn't cover everything. You need to be aware that some kinds of services , like acupuncture, dental care, hearing tests and hearing aids, health care outside of the US, prescription drugs, glasses and others, may be excluded. Medicare won't cover your deductibles, coinsurance or copayments, if you have them.

There are a lot of details to how the two plans work together. Your best bet to be fully informed is to go to the Medicare website at Medicare.gov, and download or order "Medicare and You". It will give you a thorough overview.

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