The Benefits of Each Medicare Coverage by Topic
Are you confused about which services Medicare covers, and which services it doesn’t?
this article covers all the benefits you may get under Original Medicare. Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). We will also briefly go over Medicare Part C. Read on to learn more.
The Benefits of Original Medicare — Part A
Generally, the benefits you receive on Medicare Part A as a hospital inpatient, include:
- Hospital supplies and services
- Medications you will receive as part of your inpatient treatment.
- A semi-private room
- Meals
- Skilled nursing services
TIP: For Medicare hospital coverage, it’s crucial to know whether you’re considered an outpatient or an inpatient. This applies if you’re in the hospital and enrolled in Medicare. Whether you are an impatient or an outpatient can affect the amount you pay for your care. A Medicare doctor admitting you as an inpatient means Medicare Part A coverage will apply. If a Medicare doctor does not admit you as an inpatient, then Medicare Part B coverage applies (in most cases). Outpatients can possibly stay overnight at the hospital in some cases like if you’re undergoing observation.
The Benefits of Original Medicare — Part B
What types of coverage is Medicare Part B responsible for? icare Part B deals with many types of medical services and doctor visits. Take note that Medicare coverage may not work in certain situations. For example if a service is not in a Medicare enrolled facility, then Medicare may not cover that service. Costs such as deductibles and copayments may apply. Below is a list of what Medicare Part B covers, but not limited to:
- Diabetic supplies
- Ambulance services
- Second opinion before surgery
- Durable medical equipment (DME)
- Mental health services
- Preventive services, such as vaccinations and annual checkups (wellness)
Medicare Part A, Part B, or in some measure both, may cover some services depending on the situation. For instance, cataract surgery may be inpatient surgery (which Part A covers) or outpatient surgery (which Part B covers).
TIP: Does Medicare cover prescription drugs? Generally, medications you take at home are not covered by Original Medicare (Part A and Part B). If you are in hospital inpatient care, Part A will cover the drugs you receive. If you are an outpatient, Part B will cover certain drugs you may receive. Usually, your doctor will administer these drugs to you at the doctor’s office. You must sign up for Medicare Part D for most prescription drug coverage. This coverage is optional and is available through private insurance companies.
What if you have a disability but are not yet 65, do you qualify for Medicare coverage?
You may qualify for Medicare if you are eligible for Railroad Retirement Board or Social Security benefits.
The Benefits of Medicare Advantage (Medicare Part C)
Many Medicare Part C (Medicare Advantage) plans offer benefits that Original Medicare doesn’t. Benefits like vision or routine dental services, or prescription drugs in most cases. Private insurance companies that are Medicare-approved offer these Medicare Advantage plans. They also have to include as much coverage as Medicare Part A and Part B (other than hospice services). Medicare Advantage plans vary in terms of cost and availability. However, if you’re enrolled in a Medicare Advantage plan, it doesn’t change the fact that you have to pay your Medicare Part B premium.