What Does Medicare Cover?

It’s hard enough to be in need of medical care and have to wade through an unwieldy system to understand what is, and isn’t, covered. Medicare is one such system and although it is beneficial as a source of low cost health coverage, it has limitations. If you’re a Medicare recipient, don’t wait till you need your coverage to ask “What does Medicare cover?”.

The Basics Of Medicare Part A: Inpatient Coverage

There are three primary types of Medicare coverage. Medicare Part A is the insurance that covers all forms of inpatient care. This includes hospitalization, skilled nursing and home healthcare. Medicare Part A will cover the majority of the costs of hospitalization for the first 60 days however, after which your responsibility for costs titrates up the longer you are hospitalized. If you require skilled nursing care, Medicare will cover the first twenty days and a portion of the costs for the next 80. Nearly all the costs are covered for hospice care under Part A.

Medicare Part B: Outpatient Coverage

Medicare Part B is also provided automatically to people eligible for Part A but there is a monthly cost that is based on your income. Part B covers 80% of the cost of outpatient care such as physician’s visits and medical equipment and 50% of psychological services. There are some grey areas in this coverage and if you’re unsure, don’t be afraid to ask your primary care physician “What does Medicare cover?”. Medicare Part B also covers a portion of the cost of lab work as well as preventative screenings.

Medicare Part D: Prescription Coverage

Medicare Part D is optional prescription drug coverage that will cost you a monthly premium and has a yearly limit, or cap. Your cost responsibilities include a copay and the cap at this time is $2830 but is calculated by adding the amount paid by both you and the insurance.

Don’t Wait For A Health Crisis

If you are a Medicare recipient, it’s important to understand both your rights and obligations for coverage before anything catastrophic occurs. The last thing you want to be asking yourself if you’re hospitalized is “What does Medicare cover?”.

7 Responses to “What Does Medicare Cover?”

  1. Kathy Grubbs says:

    I was recently diagnosed with lichen planus (mouth) and severe lichen sclerosis (genital area). Tests that were taken to determine the condition and doctor visits were not covered by Medicare. I am confused as to the rationale. Please advise what, if any, steps I can take. My supplemental policy is Blue Cross. Thank you.

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