DOMESTIC POLICY

Domestic Policy Paper



Domestic Policy Paper

Introduction

Medicare was first designed and implemented in the mid-1960s. By the early 1970s, Medicare benefits expanded to include individuals suffering from permanent disabilities or end-stage renal disease. Medicare provides hospitalization insurance (Medicare Part A) to individuals who receive Social Security benefits. Medicare also offers supplemental medical insurance (Medicare Part B) to help pay for non-hospital services such as medical surgical supplies, physician's or surgeon's services as well as medical services obtained at your local doctor's office and so forth. Individuals or elderly parents who receive Medicare Part B pay extra for those benefits. However, to help fill in gaps in Medicare coverage, Medicare recipients may also supplement benefits with private insurance policies that are referred to as Medigap insurance policies.

Medicare Part A is provided free of charge to individuals over the age of 65 or those who are eligible for Social Security benefits or Railroad Retirement benefits. This portion of the Medicare program covers inpatient hospital care, long-term care, and skilled nursing facility care as well as some home health care and hospice care. Benefits begin the day the beneficiary is admitted to the hospital and ends if they haven't been hospitalized for 60 consecutive days.

Beneficiaries to this portion of Medicare are usually limited to about 90 days per benefit, although there is no limit to the number of benefits in a beneficiary's lifetime. Skilled nursing facility (SNF) care is covered only if it occurs within 30 days of a three-day or longer stay in an acute hospital facility and is certified as being medically necessary. Individuals utilizing the benefits of skilled nursing facilities under Medicare are limited to a 100-day stay at that facility. Co-payments are required for the 21st through the hundredth day. Consumers are also advised to be aware that Medicare Part A doesn't cover skilled nursing facility care if the patient doesn't require skilled nursing care or rehab services.

Home health care under Medicare Part A has no limitations on length of stay, no co-payments, and no deductibles. However, in order to qualify for reimbursement for Medicare for hospice care, patients and/or elderly parents are required to relinquish their standard Medicare benefits for treatment of terminal illnesses in order to receive the hospice care benefits.

Medicare Part B covers such services as physician and surgeon services, and may cover services by podiatrists, chiropractors, dentists and so forth. (Always check first). Medicare part B also offers coverage for Medicare approved practitioners who aren't physicians, such as clinical social workers, physician's assistants, and others working with a physician.

These services also cover outpatient clinic or emergency department services, including same-day ambulance services and surgeries. Medicare Part B may help to cover home health care that is not covered under Medicare Part A. Always check to make sure that you are aware of what is covered and what is not covered under Medicare Part A or B! More information can be found on the government website.

Medicaid was designed to provide medical assistance to individuals ...