What is Medicare?

Sunday 25 July 2010 - Filed under Indiana Medicare

Medicare is similar to health insurance plans that cover individuals before retirement age, but this specific form of coverage was created for seniors age 65 and older. This federal health insurance program helps pay for costs associated with illnesses and injuries.  Medicare is broken into different segments or parts.

Original Medicare consisted of two parts; Part A – the portion covering hospital related expenses, and Part B – the portion that covers medical service expenses. In general, a person is eligible for Part A if they or their spouse has worked ten years or more at a place that qualifies as Medicare covered employment.

If an individual is entitled to receive Social Security or the Railroad Retirement system, then Part A will be automatic and free of premiums. Unlike Part A, Part B is elective and requires payment of monthly premiums, the premiums are typically deducted from a person’s Social Security retirement benefit. If you are newly entering Medicare, please speak with a licensed agent as certain factors relating to Part B enrollment are time sensitive.

Medicare Part A pays for inpatient hospital, skilled nursing facility, and some home health care. For each benefit period and after the individual covers a deductible ($1,100 in 2010) Medicare pays all covered costs during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:
A total of $1,100 for a hospital stay of 1-60 days.
$275 per day for days 61-90 of a hospital stay.
$550 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance pays $137.50 per day for days 21 through 100 each benefit period.

Medicare Part B covers Medicare eligible physician services, outpatient hospital services, certain home health services, and durable medical equipment. Part B has a $155.00 annual deductible. You will pay 20 percent of Medicare-approved amounts for services after you have met the $155.00 deductible.

For more information about Medicare in Indiana visit or consult the 2010 Medicare and You booklet.

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2010-07-25  »  admin

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