Marci's Medicare Answers

Dear Marci, My Medicare summary notice this month said I have reached the limit on outpatient physical therapy covered by Medicare, but my physical therapist says that I still need treatment. What should I do? Summer Dear Summer, Medicare will cover $1,740 worth of outpatient physical therapy each calendar year, after which you must get an exception to extend coverage. Certain conditions and situations qualify you to get an automatic exception (such as if you have Parkinson's disease or require treatment to retain independent status), which means that your therapist can use a special code to bill Medicare for as much therapy as you need. If you do not have one of these conditions, your therapist can ask for an exception for you. To do this you or your therapist should fax necessary forms and a letter explaining why you need additional therapy to your regional Part B carrier. For more information call 1-800-MEDICARE. Marci Dear Marci,M/b> I know that Medicare helps pay for medical treatment in a hospital, but what about care at a psychiatric hospital? Ryan Dear Ryan, Medicare will cover 190 days of inpatient care at a psychiatric hospital during your life, and then might cover mental health care at a general hospital. For the psychiatric hospital you will only have to pay the deductible for each benefit period that you are there and coinsurance for each day, after the first 60 days. Marci Dear Marci, Is it true that you can get help paying for prescription drugs, even if you own your house? Marissa Dear Marissa, Yes, certain types of income and assets, such as your home, are not counted on the application for Extra Help, the federal program that helps pay the Medicare Part D premiums, deductible, and copays. This means you should apply even if your income is slightly above the $14,700 income and $11,500 asset limits ($19,800/income and $23,000/asset for couples). To apply, get an application from the Social Security Administration or go online to www.ssa.gov. Marci Marci's Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation's largest independent source of information and assistance for people with Medicare. To subscribe to "Dear Marci," MRC's free educational e-newsletter, simply e-mail dearmarci@medicarerights.org. Medicare Rights Center www.medicarerights.org