Frequently Asked Questions About Medicare

When it comes time for an aging loved one to seek skilled nursing care, families are often concerned about the facility costs for both short- and long-term stays. At West Hartford Health & Rehabilitation Center, we accept Medicare Part A for skilled nursing facility care and Medicare Part B.

What are some commonly asked questions about Medicare insurance coverage?

1. What is Medicare?

Medicare is a federal health insurance program for individuals 65 years and older, or certain younger people with disabilities, and people with End Stage Renal Disease. When people younger than 65 are disabled and left unable to work for a year or more, they may qualify to receive Medicare benefits. There are four parts:

• Medicare Part A (Hospital Insurance): Covers in-patient hospital stays, care in a skilled nursing facility, hospice and some home health services.
• Medicare Part B (Medical Insurance): Coverage for medical and preventative services like ambulance transportation, doctors’ services, outpatient care, medical supplies and equipment and preventive services.
• Medicare Part C: Called Medicare Advantage, Part C encompasses features of Part A, B and D (in some cases). It is a type of Medicare health plan offered by a private insurance company that contracts with Medicare.
• Medicare Part D: Covers the cost of prescription medications, not included in Parts A – C.

2. What is the Difference Between Medicare and Medicaid?

Medicare is a federal health insurance program for individuals who have reached retirement age and those with a qualifying disability. Medicaid is a joint state and federally funded program that provides health coverage to low income individuals and their families.

3. What Are the Out-Of-Pocket Expenses?

Like all insurance coverages, the policyholders are expected to pay certain expenses with their own money, in exchange for the services being provided. Some of these fees include:

• Coinsurance: A percentage you may be required to contribute for certain medical services and equipment after you’ve reached your deductible.
• Copayment: A flat fee you pay for a doctor’s visit.
• Deductible: The amount of money out-of-pocket you must pay before coverage kicks in.
• Premium: The monthly fee you pay for continued Medicare coverage.

4. What is Optum?

At West Hartford Health & Rehabilitation Center, we also accept Optum, an alternative to traditional Medicare for long-term care residents. This private insurance program, under contract with Medicare, covers your Part A and Part B benefits and various other services. Optum staff collaborates with our clinical team to deliver health promotion, clinical services and preventive care. An on-site nurse practitioner closely monitors covered residents and coordinates care and services.

To learn more about financing skilled nursing care for a loved one, contact West Hartford Health & Rehabilitation Center today!