Many people get confused with Medicare and Medicaid, what each insurance covers and who qualifies. Let’s see if we can clear some of it up for you.
Medicare is a federally funded health insurance covering those who are 65 or older or who are disabled or have End-stage Renal Failure and require dialysis.
Medicare Part A covers Hospital and Rehabilitation Care as well as Hospice or End-of-Life Care. Rehabilitation Care can occur in a Hospital or Skilled
Nursing Facility, also known as a Nursing Home. Medicare offers 100
days of rehabilitation by paying 100% for days 1-20 and 80% for days
21-100. This can get a little complicated for patients who get
discharged from care before they have utilized their 100 days. Medicare
will continue to pay for Rehabilitation Care as long as the patient is
participating AND making progress in therapy. Once the patient has
peaked on improvements, Medicare will have the facility give you a three
day notice of Medicare benefits ending.
There is not a fee to be covered by this insurance if you or your spouse have paid into the Social Security system.
Medicare Part B covers Doctor’s visits, out-patient hospital care and
home health services including nursing and therapies. This part of
Medicare costs about $100 each month.
Medicare Part C is an option to choose a private insurance company to
manage your Medicare benefits. They generally follow Medicare rules but
costs and deductibles can vary.
Medicare Part D can help with the cost of prescriptions.
You must actually apply for Medicare to activate the insurance. Just because you retire does not mean they automatically cover you. You can get more information about Medicare at www.medicare.gov or by calling 1-800-Medicare.
Medicaid is a state funded insurance program for those who
qualify. Applications are available at any Work Force Services office or
online at www.health.utah.gov. Medicaid can assist with health care, financial assistance and even long-term care in a nursing facility, if you qualify.
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