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Telehealth

Posted on May 9, 2019 at 10:10 PM

Telehealth use jumped 53% from 2016 to 2017, outpacing all other sites of care, according to a new report. But Medicare pays for telehealth services only if the beneficiary is in a rural area with a shortage of health professionals or lives in a county outside of a metropolitan area. It also limits which providers can bill for such services.


Medicare Part B (Medical Insurance) covers certain telehealth services. You pay 20% of the Medicare-approved amount for your doctor or other health care provider’s services, and the Part B deductible applies.


Your Cost: To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

Other insurance you may have

How much your doctor charges

Whether your doctor accepts assignment

The type of facility

Where you get your test, item, or service


Telehealth services include office visits and consultations that are provided using an interactive 2-way telecommunications system (with real-time audio and video) by a doctor or certain other health care provider who isn’t at your location.

These services are available in some rural areas, under certain conditions, but only if you're located at one of these places:

A doctor's office

A hospital

A critical access hospital (CAH)

A rural health clinic

A federally qualified health center

A hospital-based or critical access hospital-based dialysis facility

A skilled nursing facility

A community mental health center


Changes to Original Medicare Deductibles, Coinsurance and Out-of-Pocket Limits, Eff. January 1, 2019

Posted on October 18, 2018 at 10:45 AM

The Centers for Medicare & Medicaid Services (CMS) announced the 2019 Original Medicare cost share amounts on October 12, 2018. 


Medicare Hospital Coverage (Part A) 

Part A Deductible* $1,364 a $24 Increase

Part A Coinsurance: *Inpatient Hospital Care (Days 61 thru 90) $341 per day a $6 Increase per day

Lifetime Reserve Coinsurance: *Inpatient Hospital Care (Days 91 thru 150) $682 per day a $12 Increase per day

Skilled Nursing Facility (SNF) Coinsurance: * (Days 21 thru 100) $170.50 per day a  $3 Increase per day

* Per benefit period (A benefit period begins on the first day you receive service as an inpatient in a hospital, and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.)


Medicare Medical Coverage (Part B) 

Part B Annual Deductible $185 a  $2 Increase

New Medicare Cards are coming!

Posted on March 2, 2018 at 3:25 PM

New Medicare Cards are coming! Medicare is mailing new cards between April 2018 and April 2019. The new card has a Medicare Number unique to you, instead of your Social Security Number. Your new card will automatically come to you—just make sure Social Security has your most up-to-date address. For more information, visit go.medicare.gov/newcard.


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Medicare 2018 costs at a glance

Posted on January 15, 2018 at 6:40 PM

Medicare 2018 costs at a glance


Part A premium

Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $422 each month. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $422. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $232.

Part A hospital inpatient deductible and coinsurance

You pay:

$1,340 deductible for each benefit period

Days 1-60: $0 coinsurance for each benefit period

Days 61-90: $335 coinsurance per day of each benefit period

Days 91 and beyond: $670 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)

Beyond lifetime reserve days: all costs


Part B premium

The standard Part B premium amount is $134 (or higher depending on your income). However, some people who get Social Security benefits will pay less than this amount ($130 on average).

Part B deductible and coinsurance $183 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.


Part C premium

The Part C monthly premium varies by plan. Compare costs for specific Part C plans.


Part D premium

The Part D monthly premium varies by plan (higher-income consumers may pay more). Compare costs for specific Part D plans.


Gaps In Medicare

Posted on February 15, 2017 at 7:00 AM

Medicare DOES NOT cover the cost of routine dental care, eyeglasses, hearing aids, and most long-term services and supports.


Specifically, Medicare does not cover custodial care, which means the care for people who are unable to live independently, but do not have an acute condition requiring skilled medical services. For example, people with Alzheimer's disease or other dementias living in nursing homes would not have their residential bills covered by Medicare. If they suffered a heart attack, or came down with pneumonia, Medicare would cover medical expenses. Learn more at the National Academy of Social Insurance.


You can also visit Medicare.gov to find what Medicare covers and what gap protection you may need.


Medicare Part A & Part B doesn't cover everything. If you need certain services Medicare doesn't cover, you'll have to pay for them yourself unless you have other insurance or you're in a Medicare health plan that covers them.


Even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments.

 

https://www.nasi.org/learn/medicare/gaps-medicare

https://www.medicare.gov/what-medicare-covers/not-covered/item-and-services-not-covered-by-part-a-and-b.html

 

MEDICARE 2016 & 2017 COSTS AT A GLANCE

Posted on November 11, 2016 at 5:20 PM

Part A Premium

Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $411 each month ($413 in 2017).


Part A Hospital Inpatient Deductible and Coinsurance

You pay:

  • $1,288 deductible for each benefit period ($1,316 in 2017)
  • Days 1-60: $0 coinsurance for each benefit period ($0 in 2017)
  • Days 61-90: $322 coinsurance per day of each benefit period ($329 in 2017)
  • Days 91 and beyond: $644 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) ($658 in 2017)
  • Beyond lifetime reserve days: all costs


Part B Premium

Most people pay $104.90 each month in 2016. The standard Part B premium amount in 2017 will be $134 (or higher depending on your income). However, most people who get Social Security benefits will pay less than this amount ($109 on average).


Part B Deductible and Coinsurance

$166 per year ($183 in 2017). After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.


Part C Premium

The Part C monthly premium varies by plan. Compare costs for specific Part C plans.


Part D Premium

The Part D monthly premium varies by plan (higher-income consumers may pay more). Compare costs for specific Part D plans.

 


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