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The Different Parts of Medicare
Medicare is health insurance for people age 65 or older, under 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring dialysis or a kidney transplant. The different parts of Medicare help cover specific services if you meet certain conditions.
Medicare has the following parts:
Medicare Part A
Helps cover inpatient care in hospitals (includes critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals).
Helps cover skilled nursing facility (not custodial or long-term care), hospice, and home health care services.
Medicare Part B
Helps cover doctor services and outpatient care.
Helps cover some preventive services to help maintain a person’s health and to keep certain illnesses from getting worse.
Generally pays 80% of the Medicare-approved amount for covered services.
Medicare Part C
(Medicare Advantage Plans)
A way to get Medicare benefits through private companies approved by and under contract with Medicare.
Includes Part A, Part B, and usually other benefits Medicare doesn’t cover. Most plans also provide prescription drug coverage.
Medicare Part D
(Prescription Drug Coverage)
Run by private companies approved by Medicare, which can either be Medicare Advantage Plans or separate Medicare Prescription Drug Plans.
Helps cover the cost of prescription drugs.
Each plan can vary in cost and drugs covered.
Top Medicare billing tips
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
Billing J code examples cpt code and description J0702 - Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg ...
PR 1 Deductible Amount PR 2 Coinsurance Amount PR 3 Co-payment Amount OA 4 The procedure code is inconsistent with the modifier used ...
Coverage Indications, Limitations, and/or Medical Necessity This LCD describes conditions under which the coverage of nail avulsion/ex...
Procedure code and description 93224 - External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage;...
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Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...
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