The federal government offers Medicare, an insurance plan meant for people aged 65 years and above, people with disabilities, and those with end-stage renal disease. It’s vital to know what your health insurance policy covers and what it doesn’t.
What Medicare covers
Medicare has four parts—Part A, B, C, and D. Parts A and B are called Original Medicare and are the most common parts for which people sign up. Most people pay a monthly premium for Medicare. Here’s what the different parts cover:
Part A offers basic hospitalization coverage, such as hospital inpatient costs when you get admitted to a hospital upon a doctor’s instructions. Part A provides benefits for services like blood transfusions, walkers and wheelchairs, some healthcare services, and hospice care. This part of Medicare also offers limited skilled nursing facility coverage under specific conditions.
Part B covers medical services and preventive healthcare, such as annual tests and doctor visits. The wide range of services and tests that fall under Part B include:
- medical equipment
- hepatitis and influenza vaccinations
- diabetes supplies
- ambulance and emergency department services
- screening for diabetes, cancer, and depression
Medicare Part C, or Medicare Advantage, is sold by private insurance companies. People with Original Medicare can enroll for it. Medicare Advantage offers the benefits of Medicare Part A and Part B, along with additional coverage for dental, vision, hearing, and prescription drugs.
Part D provides prescription drug coverage not covered by Part B. These are typically medications that must be administered by a doctor, such as an injection or infusion.
What Medicare doesn’t cover
Although Medicare offers extensive coverage, it excludes some benefits. Original Medicare doesn’t cover acupuncture, eye exams, cosmetic surgeries, dental care, and hearing aids. Additionally, Medicare doesn’t cover long-term care either. Consider a separate long-term insurance policy if you think you or a loved one will require long-term care.
If you’re unsure whether a service is covered by Medicare, you can call 800-MEDICARE or consult the Medicare coverage tool.