What does Medicare cover?
Understanding the ABCs of Medicare will help you choose the coverage that is right for you.
A
Covers hospital-related services
In general, Medicare Part A covers:
- Hospital stays
- Skilled nursing care
- Short-term nursing home care
- Hospice
- Home health services
B
Covers doctor’s office visits and outpatient hospital stays
“Medical insurance,” covers medically necessary health services and supplies, like outpatient doctor visits, tests, and wheelchairs. Medicare Part B also covers preventive services, like screenings and annual wellness exams. This coverage includes but is not limited to, items like:
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health (inpatient and outpatient services)
- Limited outpatient prescription drugs
C
“Medicare Advantage” (MA) which covers both Part A and Part B with additional coverage
Medicare Part C (MA plans) are health plans offered by private insurance companies. These companies are contracted and approved by Medicare to offer plans that roll Part A, Part B, and sometimes Part D benefits into one plan.
Every MA plan must provide the same basic coverage as Medicare Parts A and B, but also provide additional benefits not covered by Original Medicare. Some plans, referred to as Medicare Advantage Prescription Drug plans (MAPDs), even include prescription coverage. Many individuals also find MA options appealing because their benefits are rolled into one plan and the plan features an out-of-pocket maximum, which caps the amount they might have to pay each year.
The two most common MA plans are HMO (health maintenance organization) and PPO (preferred provider organization).
D
Covers prescription drugs
Medicare Part D is prescription drug coverage available to anyone with Medicare Part A and/or Part B. Medicare Part D plans are offered by private insurance companies.
Understanding the Different Types of Coverage
Medicare Part A and Part B make up Original Medicare. Medicare Advantage (MA) plans cover both Parts A and B with additional coverage that could include vision, hearing, and dental benefits all rolled into one plan. Medicare Advantage Prescription Drug (MAPD) plans include prescription drug coverage.
A Medicare Supplement plan, also called Medigap, is designed to be paired with Original Medicare. A Supplement plan “fills in the gaps” and covers more costs for Medicare Parts A and B, like copays, coinsurance, and deductibles. They will usually cover the cost of care provided by any doctor, hospital, or facility that accepts Medicare. Supplements do not include prescription drug, dental, vision, or hearing coverage. You must receive your Part A, Part B, and Part D benefits through another source.
Work with our advisors to determine which combination of coverage is right for you.
Once you’ve enrolled in Medicare, what’s next?
After you select and enroll in a plan, you have access to year-round support from our client advisor team. You’ll continue to receive important updates from us including information about your coverage and benefits, the Medicare Annual Enrollment Period, and more. We’ll keep you informed so you can stay focused on the things that matter most to you.