The Medicare program, a type of public health insurance, provides different types of coverage to members. Medicare Part A provides hospital insurance coverage, Part B provides medical insurance coverage and Part C provides Part A and Part B coverage plus additional coverage not provided by Parts A and B. Part D provides prescription drug coverage.
Medicare Part A
Medicare Part A enrollment is usually a prerequisite for enrollment in other types of Medicare coverage. For people who work and pay Medicare tax (or whose spouses do so), Medicare Part A coverage is premium-free. If neither you nor your spouse has done so, you can pay monthly premiums for Part A coverage if you also enroll in Part B. Part A provides hospital insurance coverage, which includes the costs of inpatient care in hospitals, skilled nursing facility costs, hospice care costs and home health care.
Medicare Part B
Unlike Medicare Part A, Medicare Part B is not premium-free. Part B provides medical insurance coverage, which includes costs for doctors' services, hospital outpatient care, preventive services and home health care. You can enroll in Part B if you are not entitled to Part A and you do not desire to purchase Part A. Premiums for Part B may also vary according to your income level: higher income means higher premiums.
Home Health Care Coverage
Medicare only pays for home health care if you meet certain conditions. If you meet these conditions, Medicare Part A or Part B will pay for 100 percent of the costs of your home health care services and 80 percent of the Medicare-approved amount for durable medical equipment. The Medicare-approved amount is "the amount the doctor or provider can be paid. It includes what Medicare pays and any deductible, coinsurance, or copayment that you pay," according to the Medicare handbook "Medicare and You."
Home Health Care Conditions
A Medicare provider, such as a doctor or the providers who work with the doctor, is required to evaluate your health condition to certify that you need home health services. The doctor that makes the evaluation must order your care, and you must receive this care from a Medicare-certified home health agency. Home health care services include medical social services, medical supplies for use at home and part-time or intermittent home health aide services. Another condition is that you are required to be homebound, which means that leaving home requires a great effort on your part.
Tags: Medicare Part, home health, Part provides, insurance coverage, health care
