When you are working to take care of mom and dad, things can be tough and certain aspects can be overwhelming. One of the things that is really quite difficult to navigate is the health care system. For many seniors a large percentage of their medical coverage is based on government programs. Medicaid is the coverage that seniors have when they have a lower income or when they are considered to be uninsurable. However, if your parents are not in either of these groups then that does not mean that coverage or help is not available. Medicare is available for those who are disabled or aged. Medicare can be available as the primary coverage or as a supplement to their current insurance.
Understanding Your Choices
One of the biggest reasons that Medicare is so difficult to understand is that there are a wide range of different choices. These choices include: Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. Having a basic understanding of all four parts is necessary to navigate the system with your parents.
A Look at Medicare Part A
Medicare Part A is the coverage that is needed for your parents if they were to need a hospital stay or to be in a nursing home after being hospitalized. When approved it can also cover 80% of medical equipment. Plus, it covers blood if needed. These are all things that might not be covered by your parents’ regular insurance and is definitely something that you should look at together.
Medicare Part A is available for everyone who is over the age of 65. Your parents should receive their cards around 10-12 weeks prior to their 65th birthday with coverage starting the month in which they turn 65. Another situation in which Medicare will start is when you parents have been disabled for a period of 24 months or longer.
As long as one or both of your parents worked for a Medicare covered job for at least ten years, they will be able to get this insurance for hospital stays at no charge to them. The part of coverage that your parents will be responsible for is about 19% of their overall income.
A Look at Medicare Part B
Medicare Part B is the insurance available to your parents that will cover parts of care that are not covered with Medicare Part A. Basically Medicare Part B is like a government offered option so that your parents do not need to carry private health insurance. The things that would be covered with Part B include doctor visits, x-rays, lab work, pap smears, medical supplies, and outpatient care.
Your parents will have a $100 deductible and then would be responsible for 20% of all charges as the coverage is at a rate of 80%. The fee for this coverage is a rate that is less than $100 per month. In some cases, this is the best option for your parents but with needing prior authorizations and second opinions for many things, you might find that you are both happier paying a little more for private health insurance when available.
A Look at Medicare Part C
When you choose Medicare Part C for your parents, they are not getting their Medicare benefits through the government but are instead getting them through a private health care plan. The premium for this can vary from that of the basic Medicare plans through the government but is often a little more widely accepted.
A Look at Medicare Part D
Medicare Part D is the prescription drug option. This helps pay for necessary prescriptions that your parents need on a monthly basis as well as those that they might need once in a while. To learn more about Medicare Part D, Medicarehealthplans.com has a good breakdown of what is covered.
Understanding the Costs of Medicare
Medicare has pretty straight forward costs. Part A coverage is available at no cost to your parents as long as they qualify. Part B is going to have a monthly premium. Both will require your parents to pay deductibles and a percentage of their health care costs.
Understanding Doctors and Medicare
With so much red tape, many children prefer to keep their parents on private health care for as long as possible. When your parents are in the hospital, the doctors who accept their case are agreeing to work with Medicare for the coverage. When you are looking for doctors make sure to talk to them about whether or not they accept Medicare. You might find that some doctors do not accept this type of insurance. If this is the case, you will need to look for a new doctor who will. There are not typically exceptions made with doctors about whether or not they accept Medicare.
Understanding Dual Enrollment
Many people are confused about what exactly dual enrollment is. When your parents are eligible for dual enrollment, they are eligible to receive both Medicare and Medicaid. What this means is that your parents worked enough years to be eligible for Medicare, but that their current income is low enough for them to receive Medicaid benefits at the same time. The Medicaid would pick up part of their medical expenses outside of what is deemed their co-pay amount. What Medicare does not pick up is the part that Medicaid would pay for after your parents have paid down their co-pays which are commonly referred to as spend downs.
While all of this can be very confusing, the best thing that you can do is talk to your parents about their medical needs. It is also a good idea to help your parents stay active at home and to encourage them to live a healthy lifestyle.