What Medicare Does and Does Not Cover

A lot of people can be intimidated by the number of plans out there. You want to know that you’re getting the right coverage. Let’s demystify what you get out of Medicare.

Original Medicare

Medicare, as we think of it, is what’s referred to as Original Medicare. That includes Medicare Part A and Part B. Part A is hospital insurance, and Part B is medical insurance. 

Medicare Part A covers hospital stays, hospice, and care in a skilled nursing facility,home health care services, and short-term nursing home care.

Medicare Part B covers preventive exam visits, annual wellness checks, laboratory tests (x-rays and bloodwork), medical equipment, mental health care, and ambulance services.

Medicare does not cover routine dental, vision, or hearing exams. It also does not cover hearing aids, dentures, glasses, or contacts. Medicare does not cover long-term care or retail prescription drugs.

Medicare Advantage and Prescription Drug Coverage

Medicare Advantage (Part C) plans cover all the mandatory coverage of Part A and Part B and prescription drug coverage in most cases. Many plans also offer vision, hearing, and dental coverage.

Medicare Part D covers at least two drugs in each class or category as mandated by Medicare. You pay copayments and a percentage of the drug cost and the dispensing fee. If you end up in the coverage gap, Medicare will cover 75 percent of the drug’s cost.

Medicare Supplements

Medicare Supplement plans help you afford the expenses after Medicare pays its share for Part A and Part B. These costs include copayments, coinsurance, and deductibles. As of 2019, they cannot pay the Part B deductible, but these plans can often save you enough money to cover the deductible.

For all of your Medicare questions, go to Medicare on Video.

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