What Will Medicare Pay For?
Because many people are unsure what will Medicare pay for, we are providing a quick summary of the parts of Medicare and what they cover.
Medicare is a federal health insurance program. It provides coverage to people who are either 65 years or older, people with disabilities, and those with end-stage renal disease. There are four parts of Medicare plans: Part A, Part B and Part C, as well as Part D.
What Medicare Part A pays for:
Part A or hospital insurance covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.
1. Inpatient Hospital Stays: Part A pays for the cost of a semi-private room, meals, nursing care, and other hospital services and supplies. It also covers the cost of surgeries, anesthesia, and other medically necessary procedures.
2. Skilled Nursing Facility Care: If you need to stay in a skilled nursing facility for a short period after being discharged from the hospital, Part A covers the cost of a semi-private room, meals, nursing care, and therapy.
3. Hospice Care: If you have a terminal illness, Part A covers hospice care services, including pain relief, counseling, and medical care.
4. Home Health Care: Part A covers some home health care services if you are homebound and need skilled nursing care, physical therapy, or speech-language pathology services.
What Medicare Part B pays for:
Part B is also called medical insurance. It covers medically necessary services and preventive services that are not covered by Part A. Here’s what Part B pays for:
1. Doctor’s Services: This includes office visits, consultations, and surgical procedures.
2. Outpatient Services: Part B covers services that include diagnostic tests, laboratory services, and imaging tests.
3. Preventive Services: These services include flu shots, cancer screenings, and annual wellness visits.
4. Durable Medical Equipment: Beneficiaries receive coverage for the purchase of durable medical equipment, including wheelchairs, walkers, and oxygen equipment.
5. Ambulance Services are covered if they are medically necessary.
What Medicare Part C pays for:
Medicare Part C or Medicare Advantage (MA plans). It is an alternative to Original Medicare, which includes Part A and Part B. Medicare Advantage plans are offered by private insurance companies. In most cases, they include additional benefits, such as vision, dental, and hearing coverage. Medicare Advantage plans must cover all the services that Original Medicare covers, but the cost-sharing and rules may be different.
What Medicare Part D pays for:
Some people refer to these plans as prescription drug coverage. Private insurance companies offer this coverage to cover the cost of prescription drugs. Part D plans typically have a formulary, which is a list of drugs that the plan covers. The cost-sharing and rules for Part D plans may vary.
In conclusion, Medicare covers a wide range of medical services. This includes hospital stays, doctor’s visits, preventive care, medical equipment, and prescription drugs. Understanding what each part of Medicare covers can help you make informed decisions about your healthcare needs.
