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When is the best time to file for Medicare? - to
read a useful article by Bankrate, Inc. in answer to this question click on the link below.
**Click Here** to be taken to Bankrate, Inc. article on when to file for Medicare.
Medicaid planning is used to prepare for or deal with the end of Medicare benefits. The
information provided below will help you determine when or if your Medicare benefits will end and when you may need to look
into the need for Medicaid coverage to help pay for the high cost of long term care. ***Note: When a person is recieving Medicaid benefits, they continue to be covered by Medicare - however, Medicaid
becomes "secondary" health insurance. Traditional Medicare
is the health insurance program administered by the federal government. It permits you to see any doctor who will
accept you as a patient. It provides hospital and medical insurance for: - People 65 years
- Disabled individuals (24 consecutive months)
- People with End-Stage Renal Disease (ESRD)
- Spouses
of eligible workers, certain divorced persons, widows and widowers, and dependents
Medicare consists of two parts: - Part A - hospital insurance
- helps pay for inpatient hospital, skilled nursing facility rehabilitation care and some home health care.
- Part B - medical insurance - covers physician services, outpatient
hospital care, durable medical equipment, ambulance service and lab tests.
- Part
A and Part B have deductibles and coinsurance (see below)
Eligibility
is automatic if you are collecting Social Security retirement benefits. Part A is free if you have worked at least 10
years (40 quarters of Medicare-covered employment). Part B has a monthly premium. What if you do not have 40 quarters? : = If you have not worked at least 10 years,
you may be eligible to buy Part A coverage: For people having 30-39 quarters of Medicare-covered employment, they can pay
a monthly premium to obtain coverage ($285/month). For people having less than 30 quarters of Medicare-covered employment, they
may also obtain coverage for a higher monthly premuim ($518/month). Part A -
Medicare and Inpatient costs 2025 (Acute hospital care; limited coverage for skilled nursing
home, hospice and home care. No private duty nursing, no TV and no telephone; private room only if medically necessary)
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Days
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Medicare Pays
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Patient Pays (Co-insurance)
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1 through 60
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Everything after deductible is paid
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Deductible of $1,676 is owed (no coninsurance)
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61 through 90
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Everything after Co-Insurance is paid
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Daily Co-Insurance of $419.00
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91 through 150 {life time reserve days - once per life-time}
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Everything after Co-Insurance is paid
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Daily Co-Insurance of $838.00
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151+
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Nothing
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All costs**
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$800/day while using your 60 lifetime reserve days
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**Supplemental insurance or Medicaid can help cover these costs
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Part A - Skilled Nursing Home Rehabilitation 2025 This coverage begins after a hospital-related
medical stay for of 3 days of full admission to a hospital. (Ongoing coverage beyond the first 20 days is subject to patient's
ability to benefit from continued therapy and exhibit medical improvement. When patient becomes a chronic care patient
all Medicare coverage is discontinued)
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Days
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Medicare Pays
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Patient Pays
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1 through 20
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Everything
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Nothing
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21 through 100
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Everything after Co-Insurance is paid
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Daily Co-Insurance of $209.50
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101+
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Nothing
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All costs
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**Supplemental insurance can help cover these out-of-pocket costs or they can be covered by Medicaid,
if you are eligible.
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- Coverage of Skilled Care includes: Semi-pvt room, meals, skilled nursing care, PT, OT, Speech-language
therapy, medical social services, medications, medical supplies, ambulance transport, dietary counseling.... and more.
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Part B - Premiums / Deductible 2025 (Limited coverage for physicians, outpatient services,
diagnostic tests and durable medical equipment) - Monthly
Premium: $185 per month if yearly income is $103,000 or less, if income is greater than $103,000 and less than $129,000
the premium is $244.60/month. **Higher-income consumers pay more. If premium is dedicted from your Social Security check,
then premium is reduced.
- Annual Deductible for Physician Services : $257.00/yr
Part D - Prescription Drug Coverage :
**Click Here** to be taken to our page explaining Part D Medicare
The Medicaid Program offers "special help" to pay for Medicare premiums, co-pays and deductibles for low income individuals.
**click** to be taken to our web page explaining these benefits.
To visit the official government Medicare web site click here to go to www.Medicare.gov.
For your other questions about the Medicare program, click here to go to the MEDICARE RIGHTS CENTER web page.
Click here to take Kiplinger's "Making Sense of Medicare" quiz - learn what you do and don't know about Medicare.
To read an article about 10 things that Medicare will probably not cover CLICK HERE.
Copyright - Hynes & Chu, LLP - 2025 Attorney Advertising
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