What does Medicare cover?

Question

Jeremy Harkins · Accepted Answer

Medicare covers a lot, but it does not cover everything.

Part A is mainly hospital insurance. It helps cover inpatient hospital stays, skilled nursing facility care, hospice, and some home health care.

Part B is medical insurance. It helps cover doctor visits, outpatient care, testing, durable medical equipment, mental health care, and many preventive services.

Part D helps pay for prescription drugs. You can get Part D through a separate drug plan or through many Medicare Advantage plans.

If you choose Medicare Advantage, the plan must cover almost all medically necessary services Original Medicare covers and may add benefits such as dental, vision, hearing, or other extras.

What Medicare generally does not cover includes long-term custodial care, most routine dental care, routine eye exams for glasses, hearing aids, and several other services.

And remember, Medicare coverage does not mean Medicare pays 100% of the bill. Deductibles, copays, and coinsurance can still leave you with meaningful out-of-pocket costs.

That is why the better question is often not just, “Does Medicare cover it?” but also, “What part will Medicare pay, what could I owe, and do I have additional coverage for the gaps?”

Andrea Smith · Answer

"Original Medicare", the "barebones Medicare" that we payed for through Medicare taxes being taken out of our paychecks during our working years, and typically get when we turn 65, -THAT Medicare consists of only two parts.  Part A- covers the Hospital and Part B- covers the Doctor and out patient services.  Thats it.  Part A (Hospital) + Part B (Doctor) = Original Medicare.  
   Original Medicare covers a lot but not all of your needs.  To find out everything that Medicare covers you can go to www.medicare.gov to find exactly what is covered.  
   I think its more important to point out what is NOT covered.  

Original Medicare does NOT include prescription drug coverage.  You will be penalized without drug coverage.  

The biggest thing, in my opinion, that Original Medicare DOES NOT provide is a Maximum-out-of-pocket limit.  After your deductibles are met Original Medicare will cover 80% of your Medicare covered costs.  You will be left with footing 20% of the bill.  So if that bill is $100,000 you better have your $20,000 ready to pay your share.  A medical bill for $1,000,000?  Do you have $200,000 to spare?  Does anyone?  

As a solution to these issues people usually get extra coverage beyond Original Medicare in the form of Stand-alone Prescription Drug Plans, Medicare Supplements or Medicare Advantage Plans.  These options help prevent penalties for not having creditable coverage, and help shield your pocket book from large Medical bills.

Brett Johnson · Answer

Medicare covers a lot, but it doesn't cover everything.

Original Medicare has two main parts. Part A generally covers inpatient hospital care, skilled nursing care when Medicare's requirements are met, hospice, and certain home health services. Part B generally covers your doctors, outpatient services, lab work, preventive care, durable medical equipment, and many other medically necessary services.

Remember. Original Medicare (OM) does not cover Prescription Drugs. You must get a standalone prescription drug plan (PDP).

This is why I spend time during my first consultation explaining how Medicare actually works before we ever start comparing plans. Once you understand what Medicare covers — and what it doesn't — we can determine what additional coverage, or Supplement plan works for you.

Brianna Ford-Harris · Answer

Medicare covered those that are aging into Medicare - Turning 65. Medicare is also available to those that have certain medical conditions and those that have been getting Social Security Disability benefits starting at 24 months after receiving their benefits. All services must be provided by a provider that accepts Medicare assignment.  

Medicare Part A covers hospital. This includes inpatient hospital stay, hospice care, skilled nursing facility (SNF), and home health care. This coverage is usually earned through working 10 years or more and paying taxes.

Medicare Part B is the medical. This covers services outside of the hospital like doctor visits, durable medical equipment, lab work, preventative care, outpatient services and emergency care. This is covered by a mandatory premium that is charged to the beneficiary.

Victoria R. Trevino · Answer

Original Medicare only covers A & B approved services. A = hospital
B= medical. I never recommend original Medicare by itself because it leaves the beneficiary with deductibles and copays and does not include Rx coverage.

Jorge Collado · Answer

Medicare Part A (Hospital Insurance)Part A pays for care when you stay overnight in a facility. Care you get after an official hospital admission.
Skilled nursing facility care: Short-term rehabilitation care.
Hospice care: End-of-life comfort care.
Home health services: Part-time nursing or therapy after a hospital stay. 

Medicare Part B (Medical Insurance)Part B pays for doctor visits and services outside of a hospital stay.

Galina Koval · Answer

Part A covers hospital stay and hospice, and Part B covers doctors visits, lab and outpatient services.

What does Medicare cover?

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