Medicare does not cover 100% of healthcare costs. In fact, there are many “gaps” in coverage. As MedicareAdvocacy.org reports, both Part A and B programs within Medicare have gaps in coverage that may be covered by Illinois Medicare supplements:
Medicare Part A Gaps
Medicare Part A (also known as Hospital Insurance) covers inpatient hospital, inpatient skilled nursing facility, home health, and hospice services. The following is a partial list of gaps in coverage that are not reimbursed by Medicare:
· Hospital deductible per spell of illness ($1068 for 2009);
· Hospital coinsurance payments (Medicare covers the first 60 days in full after the deductible has been met; the daily coinsurance payment for days 61 to 90 is $267 per day in 2009, and for days 91 to 150, the “lifetime reserve days,” $534);
· Hospital services beyond 150 days per spell of illness;
· Skilled nursing facility coinsurance payments (Medicare covers the first 20 days in full; the daily coinsurance payment for days 21 to 100 is $133.50 per day in 2009);
· Skilled nursing facility services beyond 100 days per spell of illness;
· Home health aide services that are provided on more than a part-time or intermittent basis;
· Home health nursing and aide services when there is no longer a skilled care component;
Investing in an Illinois medicare supplements plan can provide health services not included in Part A.
Medicare Part B Gaps
Medicare Part B (also known as Supplementary Medicare Insurance) provides coverage for a variety of outpatient and physician services. It also pays for durable medical equipment, prosthetic devices, supplies incident to physician’s services, and ambulance transportation. The following is a list of gaps in coverage that are not reimbursed by Medicare:
· Part B deductible (an annual deductible – $135 in 2009- must be met before Medicare will make payment for covered services);
· Part B 20% coinsurance payment (Medicare pays 80% of the approved charge for all Part B services and items, an amount that varies according to the services and items provided);
· Balance billing above the Medicare-approved charge (many physicians and providers charge more than the amount Medicare approves);
Because of these many holes in coverage, Medicare beneficiaries must attain Illinois medicare supplement insurance to cover the costs. Medicare Supplements For You helps you in your search for the ideal supplemental insurance plan for your needs.
