When it comes to Medicare insurance, Texas seniors can have some confusion. This is a basic guide to the four types of Medicare coverage and their limitations. The first type of Medicare coverage is Part A. Most people know that Part A covers the cost of hospital care. But, it also covers stays at skilled nursing facilities, hospice, and home health care. This form of Medicare covers all the costs for a hospital stay until the 61st day. At that point, the patient has to start picking up part of the tab. After 150 days, the patient has to cover the entire tab. Each year, a patient must cover the Part A deductible before Medicare picks up any costs.
Medicare Part B covers the cost of medical services not related to a hospital stay. This includes doctors’ services, home health care, outpatient services, and other related medical services. The types of services covered by Part B must be medically necessary or in the form of preventative care. This coverage does not cover voluntary services deemed medically unnecessary. Part B coverage has an annual deductible attached to it. When looking at Medicare insurance Texas residents need the best information.
Patients also have to cover Part B excess charges. According to Medicare law, doctors do not have to accept the amount Medicare considers a fair charge. The doctor has the option of billing the patient for up to 15% more than Medicare considers a fair charge. Since Medicare only covers 80% of these charges anyway, the patient must cover the 20% plus the excess charges the doctor puts on top. For example, if the doctor performs a procedure for which Medicare offers $100, the doctor has the option of charging $115 for the procedure, or 15% above the Medicare allowance. Medicare will pay 80% of the $100, or $80. The patient must cover the $20 left over, plus the additional $15 the doctor charged on top. In Medicare insurance, Texas seniors need to understand these nuances.
Two other types of Medicare exist. Part C Medicare is an HMO type option for those on Medicare. These plans are also known as Advantage plans. Texas Medicare Part D is the prescription drug coverage. Private insurance companies provide administration for Part C and Part D using federal guidelines for coverage.
Most seniors elect to go with some type of Medicare Supplement Insurance also known as Medigap coverage, these plans will fill in all the holes left with your traditional coverage offered from the government. When it comes to Medicare insurance, Texas residents will find it is important to find the right coverage for your needs. Since all have premiums, cost is a very important factor.
For more information on Medicare insurance Texas visit www.MedicareInsuranceTexas.com today!