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FAQ: What Does Medicare Insurance Cover?

What Does Medicare Insurance Cover?

When you first qualify for Medicare, it can be confusing to navigate this new system. The first (and most important) question is: “What does Medicare actually pay for?”

Medicare is broken up into four parts. Most people enroll in Original Medicare (Part A and Part B), which covers the majority of services. Others may choose to enroll in Part C or Part D for an additional cost. Each of these Medicare plans will pay for different items and services.

What Will Medicare Part A Pay For?

Medicare Part A (hospital insurance) is available to most Americans at the age of 65, as long as they are collecting retirement benefits from Social Security.

Medicare Part A will cover:

  • Home health care
  • Skilled nursing facility care
  • Inpatient care in a hospital
  • Hospice care
  • Inpatient care at a skilled nursing facility (not including custodial or long-term care)

What Does Medicare Part B Cover?

Medicare Part B (Medical Insurance) covers the medical services and supplies that are necessary to treat a health condition. It will also pay for some preventive services. If you are considered eligible for Part A, then you are also eligible for Part B.

Medicare Part B will cover:

  • Ambulance services
  • Durable medical equipment (DME)
  • Clinical research
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Limited outpatient prescription drugs
  • Getting a second opinion prior to surgery

What Is Medicare Part C?

Medicare Part C, also known as Medicare Advantage plans, describes private insurance policies approved by Medicare. These policies offer additional coverage, such as dental, eye, and prescription drug coverage, for a higher cost. When you enroll in Medicare Part C, though, you can only visit doctors in your network.

What Is Medicare Part D?

Original Medicare only covers medications that are administered in a hospital setting, such as injections and infusions. Medicare Part D will help you pay for your regular prescription drugs. Keep in mind that you must pay more for this optional Medicare plan.

Will Medicare Cover the Cost of Walkers and Wheelchairs?

Yes! Medicare Part B will help to cover the cost of medically-necessary in-home medical equipment such as wheelchairs and walkers.

Does Medicare Cover Dental Procedures?

Original Medicare, Part A and B, will rarely pay for dental care. You may select a Medicare Advantage plan that covers dental services, purchase supplemental insurance, or pay these costs out of pocket.

What Does Medicare NOT Cover?

Unfortunately, Medicare does not cover everything. For example, Part A and Part B will not cover most dental care, hearing aids, eye exams, and cosmetic surgeries. Additionally, no Medicare plan will cover long-term care, so it may be wise to consider a separate long-term care insurance policy.

Why Do Some Seniors Choose a Medicare Supplement Plan?

Even when Medicare does cover a medical service, you can still expect to pay for a copayment or deductible. That’s where Medigap plans come in. Medigap policies, or Medicare Supplement insurance, close the “gap” between what Medicare pays and what you owe. Find out if a Medigap plan is a good fit for your needs when you explore the My Medigap Plan website and check out our easy-to-use Medicare Supplement online quote tool.

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