If you’re acting as the primary caregiver for an aging parent or other elderly loved one, it is important that you have at least a basic understanding of the intricacies of the Medicare system as it will likely be your primary means of covering Mom or Dad’s medical expenses.
Even within the Medicare program, not all coverage is created equal. You likely already know that Medicare coverage comes in lettered “Parts,” but do you know what kind of coverage each of those Parts actually offer—and whether or not Mom is even covered?
Below, we offer a breakdown of just what kind of coverage—and additional expense—you can expect from Medicare Part A, B, C, and D.
Medicare Part A
Medicare Part A is hospital insurance which is free to everyone that is either 65 or eligible because of disability.
It will cover or defray expenses that Mom will incur during a stay at a hospital or other medical facility that offers skilled nursing care—room, tests, medication, nursing—if certain requirements are met:
- Your mother is officially admitted to the hospital by a doctor
- She needs at least 2 nights of care that she could only receive at the hospital
- The hospital accepts Medicare payments
Note that Medicare Part A will not cover all expenses, so there is usually a need for additional insurance to cover the costs of eldercare in Alabama.
Medicare Part B
Medicare Part B acts as a supplement for the Part A program.
Part B will cover or defray the cost of medical services and equipment that are deemed “medically necessary” in the diagnosis or treatment of a specific condition. This coverage also includes ambulance services, but only in emergencies and only to the nearest emergency facility.
Note that this coverage does have a yearly deductible that you must pay before insurance will begin paying for services. Once your deductible is met, you will then be responsible for approximately 20% of your medical expenses.
Medicare Part C: Medicare Advantage Plans
Some seniors opt to forgo traditional Medicare—Parts A and B—in favor of Medicare Advantage plans, what is sometimes referred to as Medicare Part C, offered by private insurance companies.
Authorized by Medicare, private insurance companies offer plans that combine coverage typically found in part A and part B. This combined plan comes with additional benefits and saves patients up front on premium costs. This program is good for younger seniors who don’t need as much care because the costs of this plan rise as care levels increase.
Many of these plans offer prescription drug coverage, also known as Medicare D.
Part D: Prescription Drug Coverage
Traditional Medicare does not come with prescription drug coverage, so seniors must sign up for Medicare part D in order to get their prescriptions covered by insurance.
While you may still pay towards a deductible before your prescription drugs are covered, Medicare part D helps seniors afford necessary medications. You can also help your Mom or Dad sign up for Extra Help for medication coverage, if they are not able to afford their medications.
Here’s the Bottom Line:
In essence, if you need to pay for eldercare in Alabama, the Medicare choices you make will depend on the type and level of coverage you need.
- Medicare Part A covers very little outside of hospital stays.
- Adding on Medicare Part B gives you more coverage, including routine medical care visits with providers.
- Part C will give you a choice between Medicare approved plans that provide a combination of Part A and Part B (and often Part D) services.
- Medicare Part D will help cover medication costs.