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Part A – B

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Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessary to treat a disease or condition. In general, Part A covers:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care (as long as custodial care isn’t the only care you need)
  • Hospice
  • Home Health Services

Part B covers two types of services

  1. Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  2. 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.

You pay nothing for most preventive services if you use a health care provider who accepts assignment. Part B covers things like:

  • Clinical research
  • Ambulance services
  • Durable medical equipment (DME)
  • Mental Health
    • Inpatient
    • Outpatient
    • Partial Hospitalization
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs

What Medicare Does Not Cover: Medicare doesn’t cover everything.  If you need certain services that Medicare does not cover, you will have to pay for them yourself unless you have other insurance or you’re in an Advantage Plan that covers these services.  Even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments. Some items and services that Medicare does not cover include:

  • Long-term care (also called custodial care)
  • Most dental care
  • Eye examinations related to prescribing glasses
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitting them
  • Routine foot care

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