Many seniors are enrolled in Medicare, the federal government’s health insurance program.
Here are some frequently asked questions about Medicare.
What are the different parts of Medicare?
Different parts of the Medicare program cover different aspects of healthcare you may need.
Click here for an overview of Medicare Part A, Part B, Part C, Part D and Medigap.
When do I sign up for Medicare?
If you receive Social Security checks, you will likely be automatically signed up for Medicare Part A and Medicare Part B when you turn 65. You can opt out of automatic enrollment.
If you don’t receive Social Security, you should sign up for Part A and B and/or Part C and D plans within three months of your 65th birthday — or within six months of your 65th birthday for Medigap policies — to receive full coverage and the lowest premiums.
There are usually late enrollment penalties if you wait to sign up for the various parts of Medicare coverage. Click the links above for more details about how to sign up.
What if I want to change what Medicare coverage I get?
Every year, there are open enrollment periods when you can review your coverage and, if you choose, change to a different plan.
Will Medicare pay for nursing home care?
In most cases, no.
If you’re moving to a nursing home for long-term care including custodial care — help with daily tasks like eating, bathing and dressing — Medicare will not cover the cost to live there. Click here to read more about this.
However, Medicare can still help you pay for doctor visits, hospital stays and medical supplies while you’re in the nursing home.
If you’re moving to a nursing home to recover after a hospital stay, Medicare may pay for a short-term stay there. See the question below for more information.
Will Medicare pay for inpatient rehab therapy services?
Yes, if you meet the following conditions:
- You were admitted to a hospital as an inpatient — not just under observation or for emergency room care — for at least three consecutive midnights
- You are enrolled in Medicare before your hospital stay
- A doctor has prescribed therapy and nursing services as medically necessary for you to recover after you leave the hospital
If these conditions are met, Medicare may pay for up to 100 days of rehab therapy services — including skilled nursing care, physical therapy, occupational therapy and speech therapy — if you’re admitted to a Medicare-certified rehab location within 30 days of being discharged from the hospital.
To qualify for coverage, Medicare has designations for where this after-hospital care — called post-acute care — can take place, including:
- Skilled nursing facilities, nursing homes and skilled care centers
- Inpatient rehabilitation facilities
- Long-term care hospitals
Will Medicare pay for outpatient rehab therapy services?
Yes, if they’re deemed medically necessary. Click here to read more about this.
There are yearly maximums for how much outpatient therapy Medicare will pay for.
Once these therapy caps are reached, you may be responsible for paying for the services out of pocket, or with a supplemental insurance plan.
Will Medicare pay for home care services?
In most cases, no.
Medicare doesn’t cover routine home care services, around-the-clock care, or personal care in your home.
Medicare will pay for short-term home care services if you’re homebound and need short-term skilled nursing care to recover from an illness, injury or surgery.
A doctor must prescribe the at-home rehabilitation services for Medicare to possibly cover the costs. Click here to read more about this.
Will Medicare pay for assisted living services?
No. Medicare does not cover assisted living services. Click here to read more.
What if Medicare doesn't cover what I need?
You may have other payment options available to you such as private health insurance, long-term care insurance or Veterans Affairs benefits. Click here to read about other options.
Is Medicaid part of Medicare?
Medicaid is a separate program from Medicare that helps low-income people of all ages receive medical care. Medicaid coverage and eligibility vary from state to state.
You can be enrolled in both Medicare and Medicaid.
What if I have more questions about Medicare?
To learn more about Medicare, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).