Medicare Hospital Coverage

2014 Medicare and Medigap Updates

Facts On Medicare Hospital Coverage

Medicare is a type of health insurance program run by the government of the United States to benefit people over 65 years old. It is also for the benefit of persons with disabilities who are not necessarily over 65 years old. The disability suffered needs to be long term and must prevent the person from working in order for them to qualify for Medicare. The disability need not be a physical disability per se but can be a specific type of disease. Since the rules and regulations can be hard to understand at times many people wonder about Medicare hospital coverage.

Some diseases that are covered under disability include end stage renal disease (ESRD) and Lou Gehrig’s disease (which is also known as amyotrophic lateral sclerosis). To be termed as disabled, you must have a medical condition that prevents you from doing any substantial work and the medical condition should either be expected to be fatal, or it should be expected to last or must have lasted for a minimum period of one year.

Medicare hospital coverage is referred to as Part A insurance. Part A Medicare hospital coverage is usually premium-free, that is beneficiaries do not have to pay insurance premiums to enjoy the benefit. The reason for this is usually because during their active work life, before they retired, they used to pay Medicare taxes. Part A hospital insurance is only available for citizens and people who meet the residency requirements.

If an individual does not automatically qualify for Part A Medicare hospital coverage, it is possible for them to purchase it. To be eligible to purchase Part A insurance, a person will need to either be over 65 years of age or be under 65 years of age but have a disability and you still work. Returning to work causes Part A premium free insurance to lapse. However, you can purchase premium free insurance, if you returned to work and are under 65 years, and enjoy the benefits for a maximum 8.5 years. To be able to enjoy Part A insurance, you must also have and pay premiums for Part B Insurance.

Generally, Part A Medicare hospital coverage will take care of hospice care, inpatient care in a hospital, a skilled nursing facility or inpatient care in a Non-Medical Health care facility affiliated to a particular religion. Medicare Part B covers outpatient care and other doctor’s visits. Medicare also has Part D insurance that is specifically used to cover prescription medicine.

One of the biggest complaints against Medicare hospital coverage is the long waiting period before benefits start to be received. If you are under 65, you will be claiming disability benefits. To qualify for Medicare hospital coverage, you first have to qualify for Social Security Disability Insurance (SSDI) payments. You must start the process by making an online application for disability. To even be considered, you need to either have worked for a specified number of hours or be either a dependant or a spouse of a person who has worked the minimum number of hours specified. Your approval for SSDI payments will come only after you have been disabled for 5 months. After those 5 months, you have to wait a minimum of two years for Medicare coverage to kick in.

Though a lot of people are unaware of it until it happens, medicare usually only pays around 20% of medical bills and the patient is responsible for the rest. Unless an individual has a very large amount of saving they may want to consider a medicare supplement insurance to cover the bills medicare doesn't pay. This coverage is called Medigap, and though it is purchase from private companies the plans have government rules and regulations the companies must go by.

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