Are Emergency Room Visits Covered by Medicare?

Are Emergency Room Visits Covered by Medicare?

The need to visit the emergency room is something that everyone might come across at one point or the other in their life. This can be owed to the fact that you cannot foresee accidents. Illnesses, also, sometimes come abruptly. Emergency Room visits are characteristically known to be expensive. Getting a plan that will help you cover the costs really come in handy and Medicare is one of them.

What is Medicare?

Medicare is a health insurance program for the United States that is administered by the United States federal government. This health insurance program has been in existence since 1966, providing health insurance for American citizens who are 65 years and above in age. Eligible persons must have worked in the United States and paid into the system via payroll tax.

Other than older people who are above the age of 65, Medicare also provides insurance to people younger than 65 years with a Social Security Administration-determined disability status. People with amyotrophic lateral sclerosis and end-stage renal disease are also covered by Medicare.

Medicare Health Insurance Coverage for Emergency Room Treatment

The packages offered under Medicare plan are two. These are the Part A plan and Part B plan. By just achieving the eligibility requirements highlighted earlier, you automatically qualify for Part A package. This package is a hospitalization insurance and it basically helps someone pay for:

• Limited hospitalization coverage
• Home health care
• Limited skilled nursing at home
• Limited hospice care, and
Blood after already receiving three pints

If you go directly to a facility for skilled nursing care, Medicare will cater for the services offered during the first 20 days. From the 21st day through the 100th day, Medicare will pay $97 per day.
Through the benefit period, Part A of Medicare will cover the costs for the first 90 days when medical care is necessary for the patient. It will cover all the costs during the first 60 days except the deductible. From the 61st through to the 90th day, the plan will cover all the costs but not the daily $194 coinsurance. The beneficiary is the one to pay the coinsurance costs.

The bills for emergency care treatments are usually split depending on the number of services you have received during your Emergency Room visit. Part A of the Medicare Insurance will help cater for a semiprivate room for the patient, all hospital meals, nursing services, rehabilitation services, drugs offered, X-rays, lab tests, operating room cost, recovery room costs, intensive care costs, coronary care costs, and any necessary services and medical supplies that one may require.

The things not covered in Part A include a telephone, a television, private duty nurses, and the extra cost of getting a private room – unless it is really necessary.

Medicare Part B

Part B package of Medicare is more of a medical insurance. This package caters for the payment of physician services, outpatient hospital services, visits to the Emergency Room after treatment, and being discharged, outpatient surgery, diagnostic tests, outpatient physical therapy, clinical lab services, speech therapy, medical supplies and equipment, renal dialysis and other services and supplies one may require.

If you qualify for Medicare coverage, the costs that you will have to cater for include:
• Copayment for your Emergency Room Visit
• Copayment for every hospital service offered to you
Coinsurance of about 20% of the Medicare costs approved for services offered by a doctor.

In case you are admitted to the same hospital that you had been admitted to before within three days of your initial visit, you will not have to pay the Copayment costs. This is because Part A of Medicare will cater for your second visit to inpatient care.

Supplement Plans for Medicare

While much of the treatment cost will be catered for under the Medicare plan, the additional costs that one has to cater for from their pocket can be a lot when accumulated. This can be strenuous to one’s finances. You can get relief when faced with such extra costs by purchasing a Medicare Supplement plan. These supplement plans are usually offered by private health insurance companies.

Medicare Supplement plans have proven to come in handy at very crucial moments. In fact, some of these supplement plans may offer coverage when one is not in the United States. You can do some research online for health insurance companies with the highest ratings that offer Medicare Supplement Plans.

Generally, if you qualify for Medicare coverage and you are faced with a situation that requires emergency care treatment, the cover will help you cater for the treatment costs. Also, while you can survive without a Medicare supplement plan, having one can go a long way in helping you cover the extra costs that you are responsible for.

Bellaire ER is one of the most reliable emergency care providers in the State of Texas. We are equipped with the best equipment, facilities, a team of qualified physicians, and a friendly staff to ensure that all our patients get the best medical care possible. You can always visit us at 5302 Bellaire Blvd, Bellaire, Texas for trusted care.