Medicare Insurance That Fits Your Needs

Emergency Departments (EDs) provide critical medical services to patients in the United States. The use of EDs highlights the health needs of surrounding communities and provide readily available healthcare for people who have nowhere else to seek help. According to the Centers for Disease Control and Prevention (CDC), there were 145.6 million emergency room visits in 2016. That means more than 40% of people visited an emergency room during that period. The U.S. National Library of Medicine indicates that signs that can lead to an emergency room visit include:

  • Excessive bleeding
  • Difficulty breathing
  • Chest pains
  • Choking
  • Severe pain
  • Drooping face/slurred speech

When facing a medical emergency, seek emergency care from the nearest hospital you can find. Regardless of whether you have healthcare insurance or not, you’ll never be denied emergency care. Further, your insurance provider will not charge you extra for seeking emergency care from a far off hospital. This is because of the provisions of the 1986 Emergency Medical Treatment & Labor Act (EMTALA), which guarantees public access to emergency services regardless of your financial status.

Original Medicare Vs. Medicare Advantage

Medicare insurance (Medicare Part B) covers emergency room visits including injuries, chronic illnesses, and sudden illnesses. If you visit the emergency room for a non-emergency issue, you may not qualify for coverage. Under Medicare, your emergency room costs may include;

  1. Copayments of the emergency room visit as well as hospital services received. You might not be aware of the full amount until you get your hospital bill.
  2. 20% of the Medicare payable amount for doctor visits
  3. Part B deductibles

Remember, if you’re admitted for a similar or related emergency condition within three days of the emergency room visit, this will be considered as part of your inpatient stay. In such a case, you’ll not be liable to pay your copayment for the emergency visit.

Contrary to original medicare, all the Medicare Advantage plans are obligated to make copayments for emergency room visits. In this case, the plans cover everything that is covered under the original medicare plan (Part A and part B). However, the out-of-pocket amounts may differ. For example, you may pay $80 for every emergency room visit under the Medicare Advantage plan. In some cases, you may not be liable to make any payments. For instance, some plans provide that if you’re admitted within 24 hours of visiting the emergency room, you don’t need to make your emergency room copayment. A unique benefit of the Medicare Advantage plan is that unlike the original medicare where you know your copayment amounts after receiving your bill, Medicare Advantage allows you to have this information in advance.

Medical emergencies can occur at any time even to those in healthy conditions. To protect yourself, secure a good health insurance plan to relieve you of the financial struggles related to emergency room visits. If you’re wondering how to secure your Medicare Advantage plan, reach out to a professional insurance agent such as Joel Lee Health Markets to help you choose a Medicare plan that fits your needs.