What Does Medicare Actually Cover?

Introduction This is a general guide which will help you to understand what Medicare actually covers. To learn more details about what Medicare covers, you can visit our “Medicare Guide” section at: Medicare Guide . If you would like an official guide to your benefits, you can download “Your Medicare Benefits” from the Publications page at Medicare Website or by dial their customer care line at (800) 633-4227. Now, let’s take a look at the coverage that Medicare has to offer. Medicare Website

Medicare Part A Most people don’t have to pay a premium or any type of fee for Medicare Part A. This is because you or your spouse already paid Medicare taxes when you worked. In order to get Part A for free, you or your spouse must have worked at least 40 “quarters,” meaning one quarter of a year. You will not get Part A free if you did not work for the 40 quarters or if you became disabled before the age of 65.

Hospital Stays Part A covers portions of your hospital stay including a semi-private room, meals, nursing care, hospital services and supplies, and inpatient mental health care. The lifetime limit is 190 days.

Home Health Care Benefits can include things such as part time nursing care, home health aide services, and physical, occupational, and speech therapy. Medical equipment and supplies, and social service costs are covered as well.
Medicare approves of home health care services and 20% of durable medical equipment. You must be sure that any of the providers you see are certified by Medicare. Otherwise Medicare will not pay for the services.

Hospice Care Most coverage is paid for under Part A including anything ranging from doctor visits to hospital stays, drugs to control symptoms, home health aide services, speech therapists, social workers, and more. Respite care when the patient is taken to a short-term stay facility in order to give the primary care provider some time off is also covered. Respite care can last up to five days at a time, and there is no limit to how many periods of this benefit hospice patients may have.

Medicare Part B In order to enroll in Part B coverage, you usually will have to pay a premium each month. Also, if you did not register for Part B on time, then you will have to pay a higher premium. Services can include doctors services, medical supplies, diagnostic tests, equipment such as wheelchairs and walkers, outpatient mental health care, speech therapy, and even second and third surgical opinions.

Medicare Part B (pt.3) Part B also will cover services and supplies you receive while being treated as an outpatient in a hospital and Part B will even cover the pints of blood you receive for transfusions. Finally Part B will cover you under a number of preventive services. For a full list, please visit Medicare Guide.

Not Covered Under Medicare Part A and B: In most cases, the following are not covered under Medicare Parts A and B:
Prescription Drugs (although covered under Part D as of 2006), hearing exams and hearing aids, all types of cosmetic surgery, eye exams and eye glasses, health care outside the U.S., dental care and dentures, and more.
Medicare Advantage plans are health insurance plans which you can buy from private Medicare certified companies. Medicare Advantage plans replace your traditional Medicare plans. They keep all of the services covered under the traditional plan and offer even more, usually prescription drugs, dental, eye and hearing exams, and any additional preventive services.

Get More Info! We didn’t cover every detail, but if you would like more information, please visit our Medicare Guide at Medicare Guide.