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What does Medicare cover?

Original Medicare includes both Part A and Part B Medicare plans. Medicare coverage varies depending on which plan you choose; and figuring out what is included in each plan can be confusing and time consuming. Keep reading for help understanding what is covered in each Medicare plan.

What does Original Medicare cover?

Original Medicare includes both Part A and Part B Medicare plans.

Part A Medicare coverage is hospital insurance and Part B Medicare coverage is medical insurance. You can get Part A Medicare coverage with or without Part B coverage, depending on your needs.

What does Part A Medicare cover?What does Part B Medicare cover?
Hospital care
Skilled nursing facility and nursing home care
Home health services
Hospice care
Medically necessary supplies and services
Preventative care
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An important note: The coverage listed above has limitations. For instance, Part A hospital insurance will cover part-time in-home care, but it does not cover 24-hour-a-day at-home care.

For more details about what Part A does and does not cover, go here.

For more details about what Part B does and does not cover, go here.

While you can find details online, figuring out exactly what is covered can be confusing. If you feel stuck, contact a Medicare agent for guidance.

 

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What does Part C Medicare cover?

Part C Medicare plans are also called Medicare Advantage Plans. These plans are used in place of Original Medicare. Because Medicare Advantage Plans  are offered by private insurance companies, exact coverage can vary. In general, they give you more coverage than you get from Original Medicare.

Part C Medicare plans include everything covered in Part A and Part B Original Medicare plans. They may also include additional coverage.

Part C Medicare plans give you the following plan options:

  • Preferred provider organizations (PPOs)
  • Health maintenance organizations (HMOs)
  • Special needs plans
  • Medical savings plans
  • Private fee-for-service plans

A Medicare agent can help you determine which type of coverage in this list is best for you and your budget. For example, some people may prefer a PPO plan with a set provider network, while other people may prefer a private fee-for-service plan that offers more flexibility in provider choice.

 

What does Part D Medicare cover?

Like Part C Medicare, Part D plans are offered by private insurance companies that contract with Medicare. You can add Part D coverage to Original Medicare or to a Medicare Advantage Plan. Many Advantage plans already include part D coverage.

Part D plans cover prescription drug costs. Ask your local Medicare agent for help determining exactly what prescriptions will be covered in your plan.

 

What does Medigap cover?

Medigap is a supplement to Original Medicare but it does not replace that coverage. You still need Part A and Part B Medicare if you want Medigap.

Medigap plans are also offered by private insurance companies, but they aren’t the same as Medicare Advantage plans.

Medigap coverage includes things that Part A and Part B plans do not. For example, Medigap helps pay for the following:

  • Deductibles
  • Copays
  • Coinsurance

Because Medigap is offered by private insurance companies, coverage will vary from plan to plan. A Medicare agent can help you determine what plan includes the coverage you need.

One important note: Medigap isn’t available if you have a Part C Medicare plan.

 

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What does Medicare not cover?

There are a number of services Original Medicare coverage usually does not include:

  • Dental care
  • Vision care (glasses, contacts, etc.)
  • Hearing exams and hearing aids
  • Long-term care
  • Acupuncture
  • Cosmetic surgery

Determining what Medicare covers and what Medicare does not cover can be tricky. You can use this link to look up specific items.

If you need coverage that isn’t included in Original Medicare, you may want to consider Medicare Advantage plans.

 

Choose the right Medicare coverage

If you need more information about Medicare basics, visit our comprehensive About Medicare resource. And to find out whether or not you are eligible for the plan you want, check out our Medicare eligibility page.

Need help deciding which plan includes the coverage you need? Consult a Medicare agent to learn about all of your options.

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