Health & Fitness
What Does Medicare Cover? Here’s What You May Need To Know
Plus, learn what services and products are not covered by the various parts of Original Medicare.
Original Medicare is made up of multiple parts and each is designed to cover a different set of benefits. Let’s take a look at what Original Medicare covers and how the various parts work together.
What does Medicare Part A cover?
Medicare Part A provides coverage for hospital stays and other types of inpatient care including:
- Skilled nursing facility care
- Nursing home care
- Hospice care
- Home health care
If you are admitted to the hospital or another type of inpatient facility, the bulk of your covered care will fall under Medicare Part A.
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Most people do not pay a monthly premium for Medicare Part A.
Learn more and visit MedicareAdvantage.com or call 844-919-3456 today to find out if you’re eligible to enroll and to compare plan benefits and costs where you live.
Find out what's happening in Across Americafor free with the latest updates from Patch.
What does Medicare Part B cover?
Medicare Part B provides coverage for doctor’s appointments and other types of outpatient care. This includes both preventive and medically necessary care. Other areas of care covered by Part B include:
- Clinical research
- Ambulance services
- Mental health services
- Limited outpatient prescription drugs
- Durable medical equipment
Durable medical equipment, or DME, includes things like wheelchairs, walkers, crutches and other items used around the house for medical care and assistance
Most people pay a standard monthly premium of $164.90 in 2023 although some high-income earners may pay more.¹
Medicare Part A and Part B make up what is known as “Original Medicare” and are provided by the federal government through taxpayer money.
What does Medicare Part C cover?
Medicare Part C is also known as Medicare Advantage Plan and is sold by private insurance companies.
Medicare Advantage plans are required by law to cover everything found in Medicare Part A and Part B. After that minimum coverage standard is met, a Medicare Advantage plan can then also provide coverage for certain benefits not found in Original Medicare.
Because Medicare Advantage plans are sold by private insurance companies, the monthly premiums are not standardized and may vary according to carrier, plan, location and more.
More than half of all Medicare beneficiaries are enrolled in a Medicare Advantage plan in 2023.²
There is also Medicare Part D, which provides coverage exclusively for prescription medications. Medicare Part D plans are available as standalone plans or may be included within a Medicare Advantage plan in what is known as a Medicare Advantage Prescription Drug (MA-PD) plan.
What does Medicare not cover?
As a general rule of thumb, Medicare covers services and items that are considered medically necessary and does not cover anything that is deemed to be purely for cosmetic purposes.
The list of things not covered by Original Medicare includes:
- Long-term care (also called custodial care)
- Routine dental care
- Routine vision care
- Cosmetic surgery
- Massage therapy
- Routine hearing exams and hearing aids
How to build your Medicare coverage
With so many moving parts in play, the best way to build out your Medicare coverage is to work with a licensed insurance agent. An agent will be able to confirm your eligibility, provide you with Medicare plan options available in your area and help you compare the benefits of each so you can determine which type of coverage may be best for you and your needs.
And when you’re ready to enroll in coverage, an agent can help you sign up right over the phone. Get no-obligation online quotes for Medicare Advantage plans available where you live and speak to an agent about your Medicare coverage options today.
Visit MedicareAdvantage.com or call 844-919-3456 for no-obligation quotes on Medicare Advantage plans available in your area.
¹Medicare.gov, “Costs” https://www.medicare.gov/basics/costs/medicare-costs
²Ochieng, N; Fugleston Biniek, J; Freed, M; Damico, A; Neuman, T. Medicare Advantage in 2023: Enrollment Update and Key Trends. Kaiser Foundation (Aug. 9, 2023). https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2023-enrollment-update-and-key-trends/#:~:text=More%20than%20half%20of%20eligible,enrolled%20in%20Medicare%20Advantage%20plans.
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