Category: Medicare

The ABCs and Ds of Medicare: What Does Each Part of Medicare Cover?

Medicare has several different parts, and it’s important to understand what each one is and what it covers so you can pick the best coverage option for you.

Medicare Part A is hospital insurance through Original Medicare that helps you pay for:

  • Care for an illness or medical condition that requires a stay in the hospital
  • Care in a skilled nursing home, as a follow-up to a hospital stay
  • Hospice care (medical care to make you comfortable if your doctor says you have less than six months to live)
  • Some home healthcare from a skilled nurse or aide if you can’t leave the house

Medicare Part B is medical insurance through Original Medicare that covers:

  • Doctor visits
  • Part-time skilled nursing care and health aide services if you can’t leave the house
  • Some preventive care, like an annual wellness exam, flu shots and pneumonia shots
  • Some lab tests (like blood tests and urinalysis)
  • X-rays, MRIs, CT scans, EKG and some other diagnostic tests
  • Some screenings like mammograms, colorectal and prostate cancer screenings
  • Durable medical equipment for use at home (like oxygen, wheelchairs and walkers)
  • Emergency room services
  • Services from ambulatory surgery centers (centers that provide surgery for patients who don’t have to be hospitalized)
  • Medical services and mental healthcare when you’re not in the hospital
  • A few prescription drugs that are administered by a doctor, like chemotherapy drugs

Medicare Part D is prescription drug insurance offered by Medicare-approved private insurance companies. Although each plan is different, the government requires all Part D plans to cover certain types of drugs including:

  • Anticancer
  • Anticonvulsants
  • Antidepressants
  • Antipsychotics
  • Antiretrovirals (for HIV/AIDS)
  • Immunosuppressants (for transplants)

Medicare Part C (Medicare Advantage) is provided by private insurance companies that have a contract with Medicare. Part C plans include all of your Parts A and B coverage plus extra benefits that may include dental, vision and fitness programs. Many also include Part D prescription drug coverage. With a Medicare Advantage plan, you don’t need Medicare supplement insurance.

Medicare Supplement Insurance (Medigap) is a private supplemental plan that helps you pay some of the healthcare costs that Original Medicare (Parts A and B) doesn’t cover, like deductibles, copayments and co-insurance. There are several Medicare supplement plans to choose from, but none offer Part D prescription drug coverage or extra benefits such as dental or vision.

To learn about the pros of cons of your Medicare coverage options and find out which one is best for you, visit our Medicare Learning Center and check out 3 Most Common Medicare Options.

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