What does Medicare cover?

Medicare is a federal program that provides health insurance to retired individuals, regardless of their medical condition, and some younger people with disabilities or certain health conditions.

You can receive Medicare coverage either by enrolling in Original Medicare or a Medicare Advantage Plan (typically an HMO or a PPO). Original Medicare is divided into hospital insurance (Part A) and medical insurance (Part B), which are run by the federal government. Medicare Advantage Plans (Part C) are offered by private, Medicare-approved insurance companies. Medicare Prescription Drug Plans (Part D) may also be available at an additional cost to those enrolled in Original Medicare or included in Medicare Advantage Plans.

Part A (hospital insurance) helps cover inpatient care in a hospital (but not physicians’ fees), a limited amount of post-hospital care in a skilled nursing facility, hospice care, and some home health care.

Part B (medical insurance) helps cover physicians’ services, inpatient and outpatient medical services, outpatient hospital care, and diagnostic tests. Part B covers medically necessary services or supplies and preventive services.

Part C (Medicare Advantage) plans provide benefits and services covered under Parts A and B and may offer additional coverage such as vision, hearing, dental, and other health and wellness services. Many plans include prescription drug coverage.

Part D (prescription drug coverage) plans help cover the cost of prescription drugs and are available from private, Medicare-approved insurance companies. Each Medicare Prescription Drug Plan has its own list of covered drugs.

Of course, Medicare doesn’t cover everything. You may need to purchase supplemental health insurance such as a Medigap plan (if you’re enrolled in Original Medicare) or specialized insurance (such as a long-term care policy).

For more information about Medicare coverages and costs, visit Medicare.gov.

LPL Tracking #1-586706