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What Women Need to Know About Retirement - Wiser

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Medicare Has Four Parts: A, B, “C,” and D<br />

Original Medicare Plan<br />

Medicare Advantage Plans<br />

Medicare provides this coverage Provided through an HMO or PPO<br />

Part A Part B<br />

called<br />

Hospital Medical<br />

“Part C”<br />

Part B is Private insurance companies approved by Medicare<br />

optional provide this coverage.<br />

Part D<br />

Part D<br />

Prescription Drug Coverage<br />

Prescription Drug Coverage<br />

You can choose this coverage. Most Part C plans have drug coverage. If they don’t,<br />

Private companies approved by<br />

Medicare run these plans.<br />

you may be able <strong>to</strong> choose Part D coverage.<br />

Different plans cover different<br />

drugs.<br />

Source: CMMS Medicare and You, 2007<br />

Typically, you are eligible for Medicare at age 65 if you or your spouse paid Medicare payroll<br />

taxes while in the paid labor force. If you are divorced, and were married for more than 10<br />

years, you may qualify for Medicare benefits based on your former spouse’s work record. For<br />

more information on who qualifies, go <strong>to</strong> Frequently Asked Questions at www.ssa.gov.<br />

Medicare Part A (Hospital Insurance)<br />

<strong>What</strong> is it? Medicare Part A helps pay for your inpatient care in a hospital and provides limited<br />

coverage for care and rehabilitation immediately after you get out of the hospital in a skilled<br />

nursing facility and in your home. Many people mistakenly assume that Medicare will provide<br />

for their long-term care. It will not.<br />

<strong>What</strong> does Part A cover? In addition <strong>to</strong> inpatient hospital stays, Part A covers skilled nursing<br />

facilities that provide skilled nursing and rehabilitation, hospice care, psychiatric inpatient care,<br />

and some home health care such as physical therapy ordered by a doc<strong>to</strong>r. However, these afterhospital<br />

services have very strict qualifying rules and are time sensitive.<br />

Skilled Nursing Facility: While Medicare Part A does not cover typical nursing<br />

home care, it does cover care in a skilled nursing facility. However, coverage is<br />

limited <strong>to</strong> a maximum of 100 days per benefit period, with coinsurance payments<br />

required after day 20.<br />

Home Health Care: Medicare may provide “necessary and/or intermittent”<br />

skilled nursing care, home health aids, physical therapy, and occupational therapy<br />

that are ordered by a doc<strong>to</strong>r and provided by a Medicare-certified home care<br />

agency. Medicare may also provide for durable medical equipment for use at<br />

home—things like a wheelchair or walker.<br />

Hospice Care: Medicare provides home health and other services, as well as<br />

drugs for pain relief and respite care for people with less than six months <strong>to</strong> live.<br />

Lifetime Reserve Days: If a person is in the hospital for more than 90 days,<br />

Medicare provides a <strong>to</strong>tal of 60 “reserve” days that can be used over a lifetime.<br />

40

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