What is Medicare?
Medicare is the United States federal health insurance program for people who are 65 and older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
What Does Medicare Cover?
Medicare consists of several parts, with each part covering different aspects of your healthcare:
*For a more detailed breakdown of each part of Medicare, click here.
Part A - Hospital insurance. Part A helps cover: Inpatient care in hospitals; Skilled nursing facility care (not to be confused with long-term care or ‘custodial’ care); Hospice care; and Home health care. We explain Part A in detail here.
Part B - Medical Insurance. Part B helps cover: Services from doctors and other health care providers; Outpatient care; Home health care; Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment); Many preventative services (like health screenings, annual ‘Wellness’ visits, and shots or vaccines). We explain Part B in detail here.
Part C - ‘Medicare Advantage’ programs. Unlike Parts A, B and D, Part C does not correspond to a specific aspect of your health like hospital, medical or prescription drugs. It is broad category of health insurance plans known as ‘Medicare Advantage’. Part C plans are plans offered by private health insurance companies that are approved by Medicare. Some plans offer additional coverage beyond what ‘Original Medicare’ (also known as Parts A and B together) covers and may even reduce the deductibles and coinsurance you have. Most Part C plans require you to seek care within a defined service area and within a defined network of providers. To enroll in a Part C plan, you must have, and keep your Part A and Part B active. We explain Part C in detail here.
Part D - Prescription Drug Coverage. Part D plans are plans offered by private health companies who follow rules set by Medicare, that help cover the cost of your prescription drugs (including many recommended shots and vaccines). As with Part C plans, you must live within the service area of the Part D plan you wish to join. We explain Part D in detail here.
Want more detailed information about: Parts A,B,C & D, your eligibility, or how to apply?
What is Medicare? | What Does Medicare Cover? | What Does Medicare NOT Cover? | Common Medicare Questions
What Does Medicare NOT Cover?
It’s important to remember that Medicare does not cover everything. If you need certain services that aren’t covered by Part A or B you will likely have to pay for them yourself unless:
You have other coverage (Medicaid or Employer sponsored coverage)
You enroll in Part C (Medicare Advantage Plan) or certain Medicare Supplement (Medigap) plans.
Here are some items and services that Medicare does NOT cover**:
Most dental care
Eye exams for prescribing glasses
Routine foot care
Dentures
Cosmetic surgery
Massage therapy
Routine physical exams
Acupuncture
Hearing aids and exams or fitting them
Long-term care
Concierge care (also referred to as boutique medicine, direct care, retainer-based medicine)
**Our ‘Even Better’ Medicare plan experts can help you find the Part C (Medicare Advantage) or Medigap plans in your area that may offer coverage for some of the above listed services that not covered under Original Medicare.
Common Medicare Questions
Are Medicare and Medicaid the same thing?
No, they are distinctly different programs with different eligibility requirements that can in some cases work together to cover certain healthcare needs and costs.
Medicare is a federally run health insurance program for people aged 65 and over (or individuals with certain disabilities). That means in general that the rules and operation of Medicare are the same for you in your state of residence and for your family, friends, coworkers or neighbors living in a different state.
Medicaid is a state-run financial and healthcare assistance program based entirely on an individual’s income. That means the rules for eligibility, and operations are different for you in your state than they are for your family, friends, coworkers or neighbors living in another state.
There are a few very helpful programs available to you if you think you may need assistance paying for your healthcare.
You can find more about your state’s Medicaid programs through www.Medicaid.gov by clicking here.
You can also find out if you qualify for prescription drug cost assistance offered through the Social Security Administration anywhere in the USA by clicking here.
Here at ‘Even Better Insurance’ we understand that Medicare can still be a daunting subject no matter how many helpful articles you read. That’s why our ‘Even Better’ Medicare plan experts are standing by right now to help answer all of your questions! We are here to help you navigate Medicare, find a plan and make it work for you!
What is Medicare? | What Does Medicare Cover? | What Does Medicare NOT Cover? | Common Medicare Questions