What does Medicare Cover?

If you are not yet aware of your coverage options, here is a primer to Medicare. In this article, you’ll learn how Part B covers preventive care, Part A covers inpatient hospital stays, and Part C covers outpatient hospital care. Part D covers prescription drugs and other items. These parts may seem complex, but they’re all a necessary part of Medicare. Part A and Part B each cover important aspects of healthcare, so it’s essential to know exactly what each one covers and what each part of the plan covers.

Part B covers preventive care

Once you have coverage under Part B of Medicare, you are eligible to have annual wellness visits with your primary care provider. These visits are designed to help prevent illness by developing a personalized prevention plan based on your current health and risk factors. They can also help identify any health risks and detect any inappropriate charges that might have been incurred previously. For more information about your coverage and eligibility for preventive care, read the Medicare Rights Center’s FAQ.

Most preventive services are covered by Medicare Part B, whether you’re on Original Medicare or a Medicare Advantage plan. Preventive care services aim to maintain and improve good health by diagnosing and treating conditions early. Medicare covers a variety of preventive services, including cancer screenings, obesity, and substance abuse counseling, and screenings for chronic conditions. Although these services are not mandatory, they can help you stay healthy and avoid health problems in the first place.

Part A covers inpatient hospital care

Medicare Part A pays the majority of inpatient hospital care. However, beneficiaries must pay a deductible for the first 60 days and a coinsurance amount after that. In addition, they may be responsible for coinsurance after the first three units of blood. Hospital stays can cost thousands of dollars without insurance, and Medicare Part A helps to lower the costs. Although Medicare does not cover the full cost of hospital stays, it can significantly reduce the costs of an extended stay.

Original Medicare covers inpatient hospital care. This includes stays in a hospital or skilled nursing facility. Some types of outpatient care are covered as well, including home health and hospice care. Original Medicare, or “Original Medicare,” also covers some doctor services and certain types of durable medical equipment. These programs are often referred to as Medicare Part A and B. Part A also pays for some preventive services. However, Medicare does not cover prescription drugs that are not prescribed by a physician.

Part C covers outpatient hospital care

In addition to inpatient hospital care, Part C of Medicare also covers outpatient physician and visiting nurse services. Outpatient hospital services are covered up to 20% of the total cost, and the facility fee must be less than the beneficiary’s Part A deductible ($1,556 in 2022). The copayment amounts are higher if the patient has multiple copays. Generally, a Medicare beneficiary must pay a copayment of 20% of the outpatient hospital service cost if the medical care is more than $200.

To receive coverage under Part C, a Medicare Advantage Plan must cover the same types of outpatient hospital services covered by Original Medicare. Those services must be medically necessary to treat a chronic disease, acute illness, or injury. Other covered services include ambulance services, mental health treatment, clinical research, and certain prescription drugs. Preventive services include flu shots, pneumonia vaccination, and hepatitis B vaccine.

Part D covers prescription drugs

Part D of Medicare pays for the cost of prescription drugs that are approved by the federal government. Some prescription drugs are covered by Medicare, including cold medications. However, if your doctor prescribes cold medicine for a different condition (such as asthma), your plan may not cover it. You can get help finding Medicare-approved cold medicine by searching the Internet. For more information about Medicare Part D, visit the Medicare website. In addition to learning more about Medicare prescription drug benefits, you should also learn about Part D stand-alone plans.

Part D premiums are set according to your income and coverage level. Depending on your plan, you may have to pay a monthly premium, as well as a deductible or copay. Keep in mind that no plan covers all drugs. Your plan’s deductible may be higher than the cost of a certain drug. Also, the cost of a drug can fluctuate each year. The monthly Part D premium can vary by plan type and insurer, as well as by how much coverage you need.