Difference between Medicare Part A and Part B

May 30th, 2017     Medicare

Medicare is the federal health insurance program for people who are 65 or above, certain young people who have disabilities such as end stage renal disease. Medicare includes different parts that cover specific services like Part A covers hospital insurance, Part B covers medical insurance, Part C (issued by private insurers) covers services of both Part A and Part B (and sometimes Part-D), and Part D covers drug prescription services.

It is important to know the difference between Medicare Part A and Part B while enrolling for Medicare. Lets check them out.

Medicare Part A Medicare Part B
Coverage and Services Medicare Part A covers hospital insurance. Below are the services categorized as follows:

Hospital Care: This coverage includes benefits such as meals, semi-private room, general nursing, other hospital services and supplies, care in inpatient rehabilitation facilities and mental health care in a psychiatric hospital. To know the list of hospitals which are enrolled in Medicare and choose the best hospitals, you can refer to our website //www.medicarelist.com/hospitals/

Skilled Nursing Facility Care: This coverage includes semi-private room, meals, skilled nursing care, medical social services, physical therapy, speech-language therapy, medical equipment, Ambulance transportation and Dietary counseling. To know the list of nursing-homes (along with quality ratings) which are enrolled in Medicare, you can refer to our website //www.medicarelist.com/nursing-homes/

Hospice: This coverage provides services to people who are terminally ill and have less than 6 months to live. To get the services, doctor must certify that the patient is terminally ill. To know the list of hospice which are enrolled in Medicare, you can refer to our website //www.medicarelist.com/hospice-care/

Home Health Services: Face to face interaction with the doctor is necessary to avail home health services. Patient must be home-bound. To know the list of home health agencies which are enrolled in Medicare, you can refer to our website //www.medicarelist.com/home-healthcare/

Medicare Part B covers medical insurance. Below are the services categorized as follows:

Doctors’ Services: Medicare covers medically necessary doctor services. It also covers services given by other health care providers, like physician assistants, nurse practitioners, social workers, physical therapists, and psychologists.

Outpatient Medical and Surgical Services and Supplies: Medicare covers for approved procedures like X-rays, casts, or stitches.

Durable Medical Equipment: Medicare covers costs for items such as oxygen equipment and supplies, wheelchairs, walkers, and hospital beds for use in the home. Some items may be rented.

Home Health Services: Medicare covers medically necessary part time nursing care, physical therapy, speech-language pathology services and services for people with a continuing need for occupational therapy.

Other (including, but not limited to): Medicare covers for clinical laboratory services, diabetes supplies, kidney dialysis services and supplies, mental health care, limited outpatient prescription drugs, and other services. The costs varies with each service.

Preventative Services: Medicare covers many preventative services to help the person stay healthy.

To know the list of doctors , therapists and nurses who accept medicare, you can refer to our website //www.medicarelist.com/

Cost Part A Premiums.
Most people don’t pay any premium for Medicare Part A (individuals who paid medicare taxes for atleast 40 quarters). There is monthly premium for Medicare Part A for individuals who paid medicare taxes for less than 40 quarters. Check the premium prices at Medicare Part A Premium

Part A Deductibles.

  • Hospital care:
    Patient pays a $1,316 deductible and no coinsurance for days 1– 60 of each benefit period. For example, if the hospital bill for 7 days is $20,000, then the patient will pay $1,316 and the remaining amount will be paid by Medicare.

    Patient pays $329 per day for days 61– 90 of each benefit period. If the patient is hospitalized for 65 days, then he has to pay total of $2961 [$1,316 (deductible) + 5 x $329 ($1645 co-pay)]

    Patient pays $658 per “lifetime reserve day” after day 90 of each benefit period (up to 60 days over your lifetime).

  • Skilled Nursing Facility:

    Patient pays nothing for days 1-20 of each benefit period.

    Patient pays $164.50 per day for days 21-100 of each benefit period.

    patient pays all the costs after 100 days of benefit period.

    Home Health Care: Patient has to pay nothing for home health services in the original Medicare. For certain medical equipment like wheel chair or walker, he has to pay 20% of the amount and the rest 80% is covered by Medicare Part-B.

  • Hospice: Patient has to pay not more than $5 for each prescription drug and 5% for inpatient respite care. For example, if Medicare approved $150 per day for inpatient respite care, then he has to pay $7.50 per day.
Part B Premiums.

Each person pays a premium for Part B each month which depends on one’s income. The standard Part B premium amount in 2017 is $134.

If each person pays his/her Part B premium through his/her monthly Social Security benefit, he/she has to pay less ($109 on average).

Part B deductible and coinsurance.

A person has to pay $183 per year for his/her Part B deductible. After his/her deductible is met, he/she typically pays 20% of the approved amount of medicare for most doctor services, outpatient therapy and durable medical equipment.


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Medicare And Lasik Eye Surgery

May 30th, 2017     Medicare

Lasik eye surgery is a laser procedure, performed by an ophthalmologist in order to improve eye vision by reshaping the eye’s cornea which basically means a person can get rid off eye spectacles or contact lenses permanently after the surgery. The cost for the Lasik eye surgery include surgeon fee, the costs of the vision center and cost for the care before and after the eye surgery. Although, Lasik cost will vary for each person depending on his eye condition and requirement.

What is the cost of Lasik eye surgery

The cost of laser eye surgery can range from as low as $299 per eye to up to $4,000 or more per eye depending on various factors such as eye condition, quality, location etc. However, the average price of LASIK eye surgery is about $2,500 USD per eye.

The cost of the Lasik eye surgery depends on the following factors:

  • Surgeons picked by the patients.
  • The technology used by the surgeons.
  • The type of the Lasik surgery.
  • Geographical area of the patient. Places with higher cost of living may charge high.

Does Medicare cover for Lasik eye surgery?

Medicare Part A and Part B do cover the costs of certain medical eye conditions, if the person requires hospitalization or emergency care. Original Medicare also covers eye doctor consultation and treatments to improve or cure certain chronic eye conditions such as glaucoma and cataracts, if the person’s doctor considers the treatment is necessary. However, Lasik eye surgery is not considered medically mandatory and hence it is not covered.

Not just Medicare, most other healthcare insurance also do not cover Lasik eye surgery, unless the person’s job requires perfect vision. Athletes and combat fighters sometimes qualify for full coverage. Few insurance companies negotiate reduced rates from lasik surgery providers for their customers.

Choose the best Surgeon

Lasik is a planned prodecure, so the person can do his research and choose a good surgeon to improve his eye sight and health. The quality of the eye surgeon is more important than the cost of the procedure. This kind of procedures generally have risks involved and a perfect result can never be guaranteed. So it is important to choose a well-qualified doctor.

You can refer to our website for the medicare list of ophthalmologists.
//www.medicarelist.com/ophthalmology/


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.