What is Medicare? Listed below is a basic overview.

​

Medicare is a health insurance program for people age 65 and older, people under 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (ESRD). Medicare consists of four programs: Hospital Insurance (Part A), Supplementary Medical Insurance (Part B), Medicare Advantage (Part C), and Medicare Prescription Drug Benefit (Part D). This guide focuses on the Original Medicare program (Parts A and B), also known as Medicare fee-for service.

 

 

Medicare is a defined benefit program, and only covers certain devices, supplies, drugs, and biologicals that have been determined to fall within a specific benefit category, are not excluded from Medicare coverage by law, and, in most cases, are reasonable and necessary as described in section 1862(a)(1)(A) of the Act. Medicare’s statutorily defined benefit categories are defined section 1861 of the Act.

 

What is Part A?

 

Medicare Part A - Inpatient Hospital Care is a type of hospital insurance provided by Medicare. The coverage provided by Part A includes inpatient care in hospitals, nursing homes, skilled nursing facilities, and critical access hospitals. Part A does not include long-term or custodial care. If you meet specific requirements, then you may also be eligible for hospice or home health care.

 

What is Part B?

 

Medicare Part B - Often referred to as Outpatient Coverage, Part B is medical insurance; coverage includes (but isn’t limited to) medically necessary doctor services, screenings, outpatient hospital care, and other services that Part A does not cover, such as some physical or occupational therapies and some home health care services. Part B also covers durable medical equipment.

​​

​

For immediate assistance please call

 

(215) 675-6846

​