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One of the most common questions people ask when they seek services for elder care is “What does Medicare cover?” This is important question, as elder care services can be expensive. The following information will help you better understand what Medicare covers.

Medicare coverage may offer some long-term care options. This government program is split up into:

  • Medicare Part Adrawing shows what medicare covers
  • Medicare Part B
  • Medicare Part C
  • Medicare Part D

Medicare Part A covers hospital care. This includes inpatient hospital care. It can help with skilled nursing services, hospice and some home care as long as it is prescribed by a physician.

NOTE: Most beneficiaries receive Medicare Part A free from premiums because of Medicare tax deductions during their years of employment.  

Medicare Part B is the medical portion of the insurance. This consists of outpatient physician and hospital services. Some home health services and medical equipment costs may be paid for by this insurance. Part B does come with a premium cost, and it changes each year.

Part C of Medicare coverage is for the Medicare Advantage Plans. This is coverage for private companies, such as HMOs and PPOs. Individuals with Part C may benefit from the same benefits as those with Part A and B, but are able to use services of their choosing as long as they are part of the HMO or PPO network. This coverage can help with dental, vision and some prescription drug costs.medicare coverage has several plans including medicare advantage plans

Medicare Part D is referred to as Medicare’s Prescription Drug plan. Individuals can receive their medications at a lower cost by paying an additional monthly premium. These premiums can be anywhere between $10 and $100.

What does Medicare Cover in terms of facility services and long-term care benefits?

Medicare coverage provides short-term medical care assistance to people over the age of 65. The following are what Medicare covers and how much they will cover.

For a Skilled Nursing Facility Medicare pays for 20 days at this type of facility. After those initial 20 days, they will cover 80% of the cost for 80 more days. This is only for individuals who need this type of care following a hospital stay.

what does medicare cover infographic showing many servicesWhat Medicare covers in terms of In-Home Care and skilled nursing care is very possibly for a limited time. The nursing care must be prescribed by a doctor and should only be on a part-time basis. The individual must also be confined to their home or in other words, homebound – meaning the person cannot seek care on an outpatient basis at a medical care facility. If this is your situation you may want to read our article Top 10 Questions to Ask a Home Health Care Provider.

For Alzheimer’s care only medical costs associated with the disease are covered. For late stage Alzheimer’s disease, hospice may be covered.

And finally for Hospice care, Medicare coverage involves hospice care for individuals with 6 or less months to live, but does not cover the room and board. Only charges having to do with medical care, prescription drugs and homemaker services are usually included.

Eldercare Connections Answers the Question: What Does Medicare Cover and more!

Eldercare Connections works with older individuals and their loved ones every day to help them seek support depending on their needs. If you’re in need of assistance from elder care services, contact us. We offer a free referral service providing the help you or your loved one needs in this stage of life. Contact us at 513-685-8998 or use our Contact Us form.