Many business leaders, including healthcare experts, often don't have their facts straight concerning Medicare, according to Investment News.
Katy Votava, PhD, RN, president of Goodcare.com, a consulting service, debunks several myths concerning Medicare.
Here are four common misconceptions concerning Medicare.
1. Medicare pales in comparison to employer group insurance.
Many Americans believe most physicians do not accept Medicare and it lacks great coverage. However, Medicare Parts A and B have no networks and are the most widely accepted health insurance coverage plans in the nation. Additionally, recent legislative changes ensure Medicare A and Medicare B cover a broad range of preventive health care services in full without co-payments or coinsurance.
2. Medicare covers long-term care.
Although Medicare does include skilled nursing facility and home-care benefits, those benefits are quite limited, and are based on a rather narrow definition of medical necessity. To be eligible for payment for such services, patients must first have a three-day hospital stay.
Additionally, the Medicare skilled nursing facility benefit provides beneficiaries up to 100 days each year. However, with the medical necessity guidelines, the actual Medicare skilled nursing facility national length of stay is 21 days for those who have been hospitalized. In the same way, although home-care benefits list covering 60 days, few people are authorized for home-care visits for more than three weeks to four weeks following a serious hospitalization.
3. Beneficiaries can enroll in Medicare at the end of Consolidated Omnibus Budget Reconciliation Act coverage.
This misconception results in lifelong penalties and coverage gaps. If a person becomes Medicare-eligible while on COBRA, that person must leave COBRA and use Medicare as their primary coverage. Additionally, the individual will have a new qualifying event for COBRA if they have dependents on COBRA.
Seniors with Medicare Part A and retirees with COBRA may keep their COBRA due to a special enrollment period that lasts for eight months after retirement. However, if they fail to enroll in Medicare Part B during the SEP, they are no longer eligible to enroll until the next general enrollment period, which is Jan. 1 through March 31 of the following year, with coverage beginning July 1.
4. You can enroll, but you can't leave.
Medicare beneficiaries can decline all or some parts of Medicare after being on Medicare for specific circumstances. For instance, a retiree with Medicare coverage who gets a job that meets Medicare standards may decline some or all parts of Medicare while saving on premiums.
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