Does My Medicare Health Insurance Plan Cover Emergencies?



How Your Medicare Health Insurance Plan Covers Emergencies

The answer to the question “Does my Medicare health insurance cover emergencies?” is yes. Emergencies are covered regardless of whether the Medicare health insurance plan you have is Medicare Part A or Medicare Advantage.

Medicare Part A & B vs. Medicare Advantage

Medicare Part A provides hospitalization in a semi-private room where the patient. There are deductibles that must be paid for each hospitalization based on the length of the stay. For the first sixty days of any hospitalization the patient must pay $1,156 – Medicare Part A will cover the rest of the hospital charge. For the same hospitalization, if the length last between 61-90 days the patient pays a coinsurance of $289/day. For each day starting with day 91, the patient pays a $578 copay up to the six lifetime reserve days they are granted. After those reserve days are used, the patient pays the full cost of the hospitalization.

It should be noted that Medicare does not cover a private room unless it is declared medically necessary by the attending physician. A patient may still obtain a private room if it is not “medically necessary” but the patient will be the full cost of that private room. Additionally, if the patient would like a television or phone, he/she is responsible for the cost of those amenities.

Medicare Part B covers emergency transportation by ambulance. Also included in Part B coverage is a second medical opinion for surgery that deemed to not be an emergency.

Medicare Advantage

Medicare Advantage is an alternative to traditional Medicare Parts A & B. This Medicare health insurance plan must at minimum provide the same coverage as offered by traditional Medicare but may provide additional benefits. These plans are provided by private insurers and the plans differ significantly. Some require an additional premium above the mandatory Part B premium.

Summary

It should be understood that regardless of the Medicare health insurance plan you select, emergency services will be covered. Medicare recipients have the choice between traditional coverage via Medicare Parts A & B or Medicare Advantage.



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