| Thu, Apr 21, 2011 @ 09:00 AM

Original Medicare: What’s Covered and What’s Not

Posted by Medicare Made Clear

Original MedicareOriginal Medicare has two parts, Part A and Part B. Each part provides coverage for specific health care services and each has some limits on how much care it will cover. Each part also charges deductibles, copays and coinsurance to beneficiaries.

Medicare Part A helps with the cost of care you receive in the hospital. This includes the cost of a semi-private room, meals, skilled nursing services, tests, medications, supplies, operating and recovery room services, etc. Part A does not pay for personal care in the hospital, such as help with eating, bathing or dressing, or personal services such as the cost of a phone or TV.

After you pay the deductible ($1132 in 2011), Part A pays most of the cost of hospital stays lasting up to 60 days. For hospital stays longer than 60 days, you can expect to pay a large share of the cost. In addition, Part A charges a deductible for each “benefit period.” A benefit period begins when you enter the hospital and ends when you’ve been out of the hospital for 60 days in a row.

Part A also helps pay for care received in a skilled nursing facility and through home or hospice care. Coverage limits and cost sharing apply in these situations, too, and it’s important to understand your financial responsibilities.

Medicare Part B helps with the cost of doctor visits and outpatient care for an illness or medical condition. It also covers most doctor services that you receive while in the hospital and some preventive care, such as an annual flu shot. Part B does not cover dental, vision or hearing care, except in very limited situations.

Part B charges a monthly premium based on your yearly income. In 2011, premiums range from $115.40 to $369.10 per month. (Medicare Part A is “premium free” if you or your spouse contributed to Medicare through payroll deductions for at least 10 years.) Part B also charges an annual deductible and coinsurance equaling 20% of the cost of your care.

Visit MedicareMadeClear.com to learn more about Medicare and how it works. You can also call the UnitedHealthcare® helpline to speak with one of our representatives to get information about Medicare options from UnitedHealthcare® Insurance Company; 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, 7 days a week.

The family of UnitedHealthcare® Medicare Solutions plans are insured or covered by an affiliate of UnitedHealthcare®, a Medicare Advantage organization with a Medicare contract and Medicare-approved Part D Sponsor.

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