What Does Medicare Cover?
Medicare is federal health insurance for:
- People who are 65 or older
- Some younger people (under 65) with disabilities
- People with End-Stage Renal Disease (also called ESRD)
The Different Parts of Medicare
Medicare consists of four different parts: Medicare Part A (hospital insurance), Medicare Part B (medical insurance), Medicare Part C (Medicare Advantage), and Medicare Part D (prescription drug coverage).
Medicare Part A
Medicare Part A, hospital insurance, covers:
- Inpatient hospital care
- Skilled nursing facility care
- Nursing home care
- Hospice care
Medicare Part B
Medicare Part B, medical insurance, covers two services: medically necessary and preventive and screening services. Together, Medicare Parts A and B make up what’s known as Original Medicare.
Medically necessary services include services or supplies that meet accepted standards of medical practice and are needed to diagnose or treat your medical condition. Preventive services include medical care to prevent illness or detect it early when treatment is likely to be most effective.
Part B covers things like:
- Durable medical equipment
- Shots
- Screenings
- Mental health – inpatient, outpatient, and partial hospitalization
- Ambulance services
- Limited outpatient prescription drugs
- A yearly wellness visit and more
Medicare Part C
Medicare Part C, also known as Medicare Advantage, is a way to get your Original Medicare coverage through private Medicare-approved companies required to follow Medicare’s rules. Medicare Advantage plans often include prescription drug coverage and may also include vision, hearing, dental, and/or coverage for fitness programs.
There are six different types of Medicare Advantage plans, with the first two types being the most popular:
- Health Maintenance Organization (HMO) Plans
- Preferred Provider Organization (PPO) Plans
- Private Fee-for-Service (PFFS) Plans
- Special Needs Plans (SNPs)
- HMO Point of Service (HMOPOS) Plans
- Medicare Medical Savings Account (MSA) Plans
Medicare Part D
Medicare Part D, prescription drug coverage, helps cover the cost of prescription drugs (including many of the recommended vaccines and shots).
What Does Medicare Cover?
When you just have Original Medicare (Parts A and B), the following are covered:
- Inpatient hospital care
- Skilled nursing facility care
- Nursing home care
- Hospice care
- Some home health care
- Medically necessary services including services or supplies that meet accepted standards of medical practice and are needed to diagnose or treat your medical condition
- Preventive and screening services like shots and a yearly wellness visit
If you have Medicare Parts A, B, and D, the above are covered as well as your prescription drug medications.
If you choose to get your Original Medicare coverage through Part C, Medicare Advantage, you have full Original Medicare coverage. Depending on your plan, you may also have coverage for things like dental, vision, wellness, and prescription drugs.
Get Medicare Help Now
Not sure which Medicare plan is right for you? Coastal Insurance Planning can help with all your Medicare needs, so you can have the truly peaceful retirement you deserve. Give us a call or send us an email to get started today.