Medicare in Elder Law

Medicare is a program for which all Americans age 65 and older qualify. It is not means-tested or limited to the financially needy; however, it has specific coverage limitations that are not always known to those who rely upon Medicare for care.

There are four parts to Medicare: Part A, which covers inpatient hospital stays, hospice, and doctor-prescribed home care; Part B, which covers physician fees and outpatient medical services; Part C, which grants a limited number of private providers the opportunity to offer Medicare services; and Part D, which provides for drug prescriptions with an additional monthly premium. Participation in one or more of Medicare’s parts is optional, based on your personal preferences and needs.

Part A is premium free except in rare cases. However, it should be noted that there are deductibles paid out of pocket, and the level of financial coverage drops drastically after sixty (60) days in the hospital or twenty (20) days in a skilled nursing facility. Click the link here for more information.

Part B has a monthly premium of $105 for most people. Premiums increase depending on the beneficiary’s income. For Part B, there is a yearly deductible of $147. See the link provided above for further information about the costs of Part B.

One of the frustrations people have with Medicare is the services that Medicare doesn’t provide or cover. For example, there is some coverage for in-home care, but only when it comes to treatments for acute illnesses or injuries. In other words, preventive care and care for ongoing conditions, such as Alzheimer’s, are not covered. In addition, coverage for skilled nursing care such as room and board at assisted living homes is subject to a one-hundred day cap. In order to expand coverage, some people turn to private insurers to bridge the gap between their needs and the limited services that Medicare provides. Eventually, many individuals abandon Medicare altogether, pay privately, or shift into the Medicaid program.

Planning for health care as we age is incredibly important. After all, everyone wants to receive the best care possible without burning through all of their assets to finance it. That is where Elder Law Attorneys come in. Not only can they explain how to utilize Medicare properly, they can help clarify your financial future by developing an estate plan that incorporates your health care needs into it. Speaking with an Elder Law Attorney can help avoid unexpected out-of-pocket expenses and coverage gaps due to the limitations of Medicare.

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