Medicare & You
By Rick Law of the Estate Planning Center at Law Elder Law in West suburban Kane County in Illinois. As I’ve discussed in the past, Medicare is concerned about care only as long as a person can get well. There are a few exceptions to that, due to political lobbies that were strong enough to make changes. For instance, Medicare cares for people who have amyotrophic lateral sclerosis, or Lou Gehrig’s disease, and about people with chronic renal failure. Why? Because these diseases or conditions had a big enough lobby to get the Medicare law changed. Medicare does not care about Alzheimer’s disease and was never designed for long-term care. The benefit of Medicare Hospital Insurance ( Part A) is that it helps pay for inpatient care in a hospital or skilled-nursing facility (following a hospital stay), for some home health care, and hospice care. According to the Centers for Medicare & Medicaid Services publication “Medicare & You”, Medicare covers 100 percent of medically necessary home health care services, but the individual pays 20 percent of the cost for medical equipment. Medicare covers hospice care once a doctor certifies an individual as terminally ill with six months or less to live. Coverage here includes drugs and medical costs, including equipment and services. Medicare usually does not cover things like spiritual and grief counseling. As of 2014, these were some of the things Medicare may help cover for those who are eligible:
- An individual pays nothing for hospice care, but does pay up to $5 per prescription for outpatient drugs and 5 percent of the costs for inpatient respite care.
- The individual pays a deductible of $1,156 and no copayment for the first 60 days each benefit period, $289 for days 61 to 90 each benefit period, and $578 per “lifetime reserve day” after day 90 each benefit period (up to 60 days over a lifetime).
- Individuals pay all costs for each day after the lifetime reserve days.
- Inpatient mental health care in a psychiatric hospital is limited to 190 days in a lifetime.