In general, Part A covers these services:
- Hospital care
- Skilled nursing facility care
- Nursing home care (as long as custodial care isn’t the only care you need)
- Home health services
Part A has no additional premium as long as you or your spouse have worked the necessary 40 quarters (10 years).
Part B covers 2 types of services
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
Part B covers things like:
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health
- Partial hospitalization
- Getting a second opinion before surgery
Part B has an additional premium. In 2016 this premium is about $121.80, however it can fluctuate based on income.
Part C is a type of private Medicare insurance, also referred to as Medicare Advantage. Medicare Advantage plans are private health plans that you can get your Part A, Part B, and often Part D through. In this instance, Medicare is no longer your primary insurer, the insurance company takes over as primary. These are often PPO or HMO plans that have networks of physicians. Similar to what most people have under an employer or individual health plan, these plans usually have co-pays, deductibles, and maximum out-of-pocket expenses.
Part D is a federally mandated program offered by private insurance companies that helps control the costs of prescription medications. Part D is often included in Medicare Advantage plans or purchased separately when you have a supplement or Original Medicare. What Medicare does not cover:
Some of the items and services that Medicare doesn’t cover include:
- Long-term care (also called custodial care)
- Most dental care
- Eye examinations related to prescribing glasses
- Cosmetic surgery
- Hearing aids and exams for fitting them
- Routine foot care
Some supplemental plans and Medicare Advantage plans may include some additional services that Original Medicare does not cover. Every plan is different, that is why Seniority Benefit Group is here to assist you in the process of finding the right one for you.
What Medicare covers. (n.d.). Retrieved September 20, 2016, from https://www.medicare.gov/what-medicare-covers/index.html