A Comprehensive Guide To Medicare Coverage

Medicare is the federal government program that provides healthcare benefits to Americans over the age of 65. Citizens with disabilities and chronic conditions are also eligible for these benefits.

Before you enroll for Medicare, it’s important to know what is covered and what isn’t under the four main parts:

Medicare Part A

Part A will cover hospital inpatient costs if you are admitted to a hospital with a doctor’s order. It provides benefits for services like hospice care, blood transfusions, walkers and wheelchairs, and some home healthcare services. It also provides limited coverage for skilled nursing facilities if you have a qualifying inpatient hospital stay.

Medicare Part B

Part B will cover yearly doctor visits, ambulance, and emergency department services, costs of medical equipment, and diabetes supplies. It also covers preventive healthcare like screenings for cancer, depression, and diabetes, and vaccinations for influenza and hepatitis.

To get the most coverage, people often combine parts A and B together (Original Medicare). For those looking for a private alternative to this, there’s Medicare Advantage or Part C.

Medicare Part C

Medicare Advantage is a privately sold insurance plan that includes the same coverage as parts A and B, plus extra benefits, like prescription drugs and hearing aids. These plans may sometimes also cover additional services like dental and vision.

Medicare Part D

Part B covers drugs you wouldn’t usually give to yourself, like an infusion or injection. For other prescription medications, there’s Part D. Most Medicare drug plans will have their own list of drugs they cover, called a formulary. Even if a plan’s list does not include the specific drug you take, in most cases, you’ll be able to find a similar drug.

What Medicare doesn’t cover

Original Medicare does not cover most dental care services, eye exams, hearing aids, acupuncture, and cosmetic surgeries. It also does not offer coverage for long-term care.