Prescription Coverage

 Is It Time to Have a Conversation About Long-term Care with an Aging Parent?

Like many families, mine is scattered all over the United States.  Work and other commitments make it difficult to visit distant loved ones more than a few times a year.  When visiting, it is hard to gauge the health and safety of family members because they are often not going about their normal daily activities. 

A few years ago, while visiting my dad in Oregon, I noticed that there was something not quite right with him.  He was repeating himself and telling stories about his history that I was pretty sure were not true.

Recently, I had to help a relative reinstate her Medicare Part D insurance coverage after she forgot to pay the premiums for several months.  The insurance company sent many notices advising that they would terminate coverage if the past-due premiums were not paid, but she either ignored the notices or could not comprehend what they said and eventually lost coverage.

After spending hours on the phone first with the insurance company and then with Medicare, I realized that Medicare is somewhat of a mystery to me.  Medicare is not yet my health insurance provider, so other than knowing that most of my clients are covered by Medicare and pay a monthly premium for the health insurance, I really had little idea of how Medicare works.  This blog post is a general guide to Medicare, while the next four posts will explore the alphabet of Medicare in more depth.

Medicare Part A is known as hospital insurance.  That term may be misleading, however, because services provided in the hospital by doctors, anesthetists, and surgeons are covered by Medicare Part B.  Part A covers nursing care, such as care provided by professional nurses, a semi-private room, meals, lab tests, prescription drugs, medical appliances and supplies, rehabilitation therapy.  Services provided for home health care, when you qualify, or hospice care are also covered under Part A.

Generally, the Part A premiums are paid for by the Medicare taxes withheld from your paycheck if you or your spouse has worked enough to qualify for 40 or more work credits.

If so... 

Who pays what?  Do I need insurance if I’m eligible for VA healthcare?

You’ve been approved for VA Pension or Compensation, and you will be receiving healthcare and prescription drugs at the VA facility.  You also have Medicare part B and Medicare part D.