If I am Hospitalized

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By John Graves

If I am hospitalized, does Medicare pay first, before my health insurance?

First of all, Medicare has four parts, A, B, C & D. the cost for each is determined by the SSA and depends upon your income, essentially. Benefits depend upon each part. For example, A is for hospitalization and initial skilled nursing care; part D is for prescription drug.

At age 65 you are eligible to enroll in Medicare. Each year thereafter you are eligible to enroll or change your Medicare supplemental coverage, available from private carriers. When you have a medical event, the doctor, care giver or hospital takes your information from your Medicare Card and processes it. Thus, the answer to your question is that both medicare and your supplemental insurance pay the covered expenses of your visit. They have pre-arranged how much will be paid for by each: the government and the private sector.

When you need treatment at a doctor, hospital or specialty treatment center, you only have to show your Medigap Insurance (Medicare Supplement) card to the doctor, hospital or treatment center.  Then everything will, be taken care of for you.

The fact is that, once your claim is filed with Medicare for Medicare Part B charges, Medicare will in most cases send your claim directly to your Medicare Supplement Insurance Company without you or your provider having to do anything.  Then your Medigap Insurance Company will process the claim, often without it ever touching human hands.

For Medicare Part A claims, the hospital where you receive treatment is required to file with Medicare Supplement Plans for you.  Therefore, you will never have to worry about claims hassles or paperwork .
You only need to Compare Medicare Supplements and find the one that is right for you and all is taken care of for you.  If you choose the Medigap Plan F, you will never have a remaining bill to pay.

Medicare insurance facts

If I am hospitalized, does Medicare pay first, before my health insurance?

First of all, Medicare has four parts, A, B, C & D. the cost for each is determined by the SSA and depends upon your income, essentially. Benefits depend upon each part. For example, A is for hospitalization and initial skilled nursing care; part D is for prescription drug.

At age 65 you are eligible to enroll in Medicare. Each year thereafter you are eligible to enroll or change your Medicare supplemental coverage, available from private carriers. When you have a medical event, the doctor, care giver or hospital takes your information from your Medicare Card and processes it. Thus, the answer to your question is that both medicare and your supplemental insurance pay the covered expenses of your visit. They have pre-arranged how much will be paid for by each: the government and the private sector.

Part A:
hospital care: you pay first $1,156 – your deductible – then 0 for the first 60 days. You pay $289/day thereafter, per calendar year.
Home health care: you pay 20%of approved equipment cost
SNF: 0 for 20 days, then$144.50/day yp to 100 days

Part B
Lab services = 0
You pay 20% of approved equipment cst
Mental health: you pay 40%
Medical” 20% of approved services
Outpatient: you pay the copay

Part C: Medicare advantage plans
If available, covers your entire out of pocket for A & B.
Available as PPO, HMO, SNP, & PFFS plans
Part D: drug plans
Coverage similar to C, with all costs paid by carrier

You are eligible to participate at age 65 and may change carriers each fall, as you wish, during open enrollment. Carriers may not turn you down. They have negotiated with the SSA for the coverage, costs and co-pay costs, as well as the premiums for each of you.

Do I need supplemental insurance for Medicare?

Yes. It is available to virtually all who are over 65. The SSA coverage is quite extensive and is divided into four parts, A, B, C, D. C allows you to buy supplemental coverage that essentially eliminates your co-pay, deductibles and most out of pocket expenses.

You do have to understand the coverage offered and in your area and its costs.

Your income determines what you pay for various coverages. The more you earn, the more you will have to pay.

Your health also determines what coverage you want. The extent of your current health demands will dictate the coverage you acquire. Later in life, as our health changes, coverage becomes far more intrinsic to the enrollment process.

What can be done if an executor of an estate does not fulfill his responsibilities?

Your choices are described by both the legal document – the will or Trust – and the law.

If you feel the will or Trust has been improperly followed, you can appeal to the executor. You can also appeal to the local court for resolution or restitution.

You can, ultimately, bring suit against the executor, to either have them removed and another out in his place, or to have him held financial & legally responsible for his actions.

These choices are neither timely, efficient nor inexpensive. Your first, and usually best choice, is to consult him directly, perhaps through a mediator. The mediator should be free of prejudice and able to sort through the legalese of the situation.

It is never easy to be a Trustee. Errors can be made without guilt or prejudice – or even knowledge. Few individuals have the mental, temporal or psychological wherewithal to act in accordance with the wishes of the decedent(s)..

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