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read about Medicare in Texas here.

Will Medicare Cover My Parent for the Rest of Their Life?

Medicare lasts a lifetime, but there may be some limits to the coverage. When you understand the limits, you can help your parents get supplemental coverage, such as a Medicare Advantage plan or Medicare Supplement Insurance plan.

When does Medicare Start?

Medicare coverage often begins when your parents turn 65. If they have a disability, coverage might start sooner. The Initial Enrollment Period starts three months before the month your parent turns 65. It continues for three months after that month.

During those seven months, your parent can choose between Original Medicare or a Medicare Advantage plan. Original Medicare includes Part A and Part B. Part A covers hospital care and Part B covers medical services outside the hospital. Medicare Advantage plans are an alternative way to get Part A and Part B benefits. Some Medicare Advantage plans offer extra coverage for services like dental and vision care as well as offering an out-of-pocket maximum.

Does My Parent Have to Renew Medicare Every Year?

Your parents will not have to sign up for Medicare every year once they are in the program. They can review their current coverage to see if they want to make changes. The Medicare Open Enrollment Period runs from October 15 to December 7 each year. During that time, your parent can:

  • Switch from Original Medicare to a Medicare Advantage plan
  • Change from a Medicare Advantage plan to Original Medicare
  • Change Medicare Advantage plans
  • Enroll in a Medicare Prescription Drug plan
  • Change Medicare Prescription Drug plans

 

There is one other time when your parent can make changes to their Medicare Advantage plan every year. The Medicare Advantage Open Enrollment Period runs from January 1 to March 31 every year. During this period, your parent can change Medicare Advantage plans. They can also switch from a Medicare Advantage plan to Original Medicare.

If your parent does not want to make any changes, their Medicare coverage generally renews automatically every year.

What does Medicare Cover?

Original Medicare and Medicare Advantage plans both include the following coverage:

What does Medicare cover under Part A?

  • Inpatient hospital stays
  • Hospice care
  • Skilled nursing care
  • Home health care

 

What does Medicare cover under Part B?

  • Visits to a doctor or other health care provider
  • Some preventative services like yearly wellness visits and screenings
  • Outpatient medical care
  • Home health care
  • Durable medical equipment

Some Medicare Advantage plans might also cover dental services, vision care, or prescription medications. These benefits vary from plan to plan, based on the area where your parent lives.

Does Medicare Cover All Medical Services for a Lifetime?

There is no limit on medical services covered by Medicare in most cases, although you will have a coinsurance for most services. Your parent’s providers will need to show the service is medically necessary. There are a few services that do have limits. These include:

 

Hospital Stays

Medicare covers any stay in the hospital with a coinsurance after day 60. After 90 days, your parent will pay a higher coinsurance until his lifetime reserve days are exhausted. Your parent does have 60 lifetime reserve days as well. Your parent can use these reserve days as they need them. Once they use up their lifetime reserve days, they will pay all the cost of the hospital stay. A Medicare Supplement insurance plan could extend the covered number of hospital days up to an additional 365 days after Medicare benefits are used up. Medicare Advantage plans all have out-of-pocket maximums, protecting your parent from bankruptcy no matter how many days are spent in the hospital.

 

Stays in Skilled Nursing Facilities

Your parent may need to go to a skilled nursing facility after being in the hospital for three days or longer. Medicare covers the full cost of the care for up to 20 days. After that time, Medicare covers some of the cost and your parent will pay a share, called coinsurance. After 100 days, your parent will be responsible for the full cost of the care. Up to eight Medicare Supplement insurance plans cover the skilled nursing facility coinsurance.

 

If you want to see the Medicare Supplement insurance plans available in your area, enter your zip code on this page.

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