MEDICARE Medicare is a federal government health insurance program designed to assist individuals age 65+ (and some disabled individuals including some persons with end-stage renal disease). All persons 65+ must apply for Medicare benefits which go into effect at age 65. Medicare is divided into 2 parts:       Part A: Hospital Insurance       Part B: Medical Insurance (To be eligible for Part B benefits, an individual must pay a monthly premium and be entitled to Medicare Part A.) Medicare has co-payments and deductibles. Copayments are a percentage or dollar amount of covered expense which the beneficiary is required to pay. A deductible is an initial amount the beneficiary is responsible for paying before Medicare coverage begins. Part A pays for:      All normal hospital services      Extended-care services in a Skilled Nursing Facility      Home Health Services including:      -visiting nurse      -physical, occupational, and speech therapy      -medical supplies (no drugs)      Hospice Services Part B pays for:      80% of:      Reasonable charges from doctors and other health care professionals, after deductible      Medically necessary ambulance service      Physical, Speech, Occupational Rx      Home health services ordered by a doctor      Medical supplies and equipment      Transfusions of blood and blood components on an outpatient basis      Outpatient surgery MEDICARE CRITERIA For Skilled Nursing Facility (SNF) Care      3 day prior hospital stay      Admitted to SNF within 30 days of hospital release      Must enter SNF for treatment of condition for which one was hospitalized      Must need skilled care on a daily basis      The condition must be improvable      Facility must be Medicare certified      Physician must have a written care plan that must be carried out Once daily skilled care ends, Medicare will no longer pay for the stay. This means the patient has either reached the goals or is not expected to improve in the program. Medicare generally pays for the first 20 days in full at a skilled nursing facility. It then will pay a portion of the cost of the facility up to the 100'th day. On the 101'st day forward, the facility is paid by either:      -Private Funds      -Long Term Care Insurance      -Medicaid MEDICARE CRITERIA For Home Health Care      -Must be homebound      -Must have a physician care plan      -Care must be needed intermittently      -Care Cannot exceed 35 hours/wk. or 8 hours/day or 4 days/week      -Physical/Speech Rx has no restrictions though care must be "necessary and reasonable" Home health care has no deductible. A hospital stay is not required. Medicare home health care benefits pay for patient recovery from an acute illness or injury- It does not generally pay for chronic conditions or custodial care. If a person qualifies for home health care, they are entitled to a home health aide to do personal care. On average, a patient receives 23 home health visits. For complete information on Medicare, visit: www.empiremedicare.com NOTES: Skilled Care means medically required care- usually provided by a licensed professional (M.D./R.N./P.T./O.T./etc..) on a regular basis. Custodial Care means personal care (eg.- dressing, bathing, etc..) usually provided by a personal care aide or nursing assistant. Custodial care is not covered by Medicare