Health Insurance and Medicare is a program for people age 65 or older and has Part
A (Hospital Insurance) and Part B (Medical Insurance to cover doctor’s services and
outpatient care). Medicare covers 80% of the allowable reimbursement that is available
every year and differs depending upon the region in which the individual lives. The
20% is the responsibility of the Health Insurance and Medicare member less any deductible
for the year that needs to be met.
Also, there are insurance policies available that will cover the 20 percent that
is not covered by Health Insurance and Medicare known as secondary insurances. These
“secondaries” as they are called, come in many forms and with many different systems
Medicare HMO’s and PPO’s are plans that are permitted by Health Insurance and Medicare
but are managed by private companies. PPO’s usually let the individual to only see
health care providers within the plan’s network and must have a referral to see a
In addition, home care services under these programs may be restricted and may require
additional co-pays from the subscriber. Home care under the Health Insurance and
Medicare program can provide skilled nursing, and therapies including speech and
For many patients, home care is a necessity that will allow the individual to return
home to finish recovery and treatment in the comfort of their own home, rather than
at a facility.
There are other parts of the Health Insurance and Medicare plan that are broken into:
Part A –covers hospice care and some home health care.
Part B –covers the services of physical and occupational therapists and some home
Part D – provides prescription drug coverage.
There are different types of insurances today like Health Insurance and Medicare
that are available to people and others are very complicated. People must weigh their
options carefully and know exactly what they are getting…as well as what they may
be exchanging it for!
You are the one with the insurance, and even though your provider tries his or her
best to find out on your behalf just what exactly your primary and secondary insurance
will cover, in the end, no matter what, it is your responsibility to understand your
insurance benefits and not the other way around.