Exploring What Medicare Part A and B Cover

Introduction

Medicare is a health insurance program administered by the federal government that provides coverage to people 65 years of age and older, as well as certain younger individuals with disabilities. Medicare consists of four parts: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Plans) and Part D (Prescription Drug Coverage). In this article, we will focus on exploring what Medicare Part A and B cover.

Comparing Medicare Part A and B Coverage

Part A covers inpatient hospital care, skilled nursing facility care, home health care, hospice care, and some types of durable medical equipment. Part B covers physician services, outpatient care, preventive services, laboratory services, and ambulance services. Let’s take a closer look at what is covered and not covered by Medicare Part A and B.

What is Covered by Medicare Part A?

Medicare Part A covers a variety of inpatient hospital services including: room and board charges, nursing services, meals, drugs, operating room services, and other hospital services. It also covers up to 100 days of skilled nursing facility care, home health care, and hospice care. Additionally, Part A covers some durable medical equipment such as walkers, wheelchairs, hospital beds, and oxygen supplies.

What is Not Covered by Medicare Part A?

Medicare Part A does not cover custodial care at a nursing home or long-term care facility. Additionally, it does not cover cosmetic surgery, eyeglasses, hearing aids, dental care, or routine foot care.

What is Covered by Medicare Part B?

Medicare Part B covers a variety of outpatient services including physician services, outpatient care, preventive services, laboratory services, and ambulance services. It also covers some durable medical equipment such as walkers, wheelchairs, hospital beds, and oxygen supplies. Additionally, Part B covers some preventive services such as cancer screenings, flu shots, and diabetes screenings.

What is Not Covered by Medicare Part B?

Medicare Part B does not cover custodial care at a nursing home or long-term care facility. Additionally, it does not cover cosmetic surgery, eyeglasses, hearing aids, dental care, or routine foot care.

Exploring the Benefits of Medicare Part A and B

Medicare Part A and B offer a wide range of benefits for people who are eligible for Medicare. These benefits include:

Hospital Care

Part A covers inpatient hospital care, including room and board charges, nursing services, meals, drugs, operating room services, and other hospital services. It also covers up to 100 days of skilled nursing facility care.

Skilled Nursing Facility Care

Part A covers up to 100 days of skilled nursing facility care for people who have been hospitalized for at least three days.

Home Health Care

Part A covers home health care for people who need intermittent skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy.

Hospice Care

Part A covers hospice care for people who are terminally ill and have a life expectancy of six months or less.

Durable Medical Equipment

Part A and Part B both cover some types of durable medical equipment such as walkers, wheelchairs, hospital beds, and oxygen supplies.

Outpatient Services

Part B covers a variety of outpatient services including physician services, outpatient care, preventive services, laboratory services, and ambulance services.

Comprehensive Overview of Medicare Parts A and B

In addition to the services listed above, Medicare Part A and B also cover the following services:

Inpatient Care

Part A covers inpatient hospital care, including room and board charges, nursing services, meals, drugs, operating room services, and other hospital services. It also covers up to 100 days of skilled nursing facility care.

Physician Services

Part B covers physician services, including office visits, diagnostic tests, and surgeries.

Preventive Services

Part B covers preventive services such as cancer screenings, flu shots, and diabetes screenings.

Laboratory Services

Part B covers laboratory services such as blood tests, X-rays, and other diagnostic tests.

Ambulance Services

Part B covers ambulance services when medically necessary.

Guide to Understanding Medicare Part A and B Coverage

When considering whether or not to enroll in Medicare Part A and/or Part B, it is important to understand the cost-sharing requirements, premiums, deductibles, and co-insurance associated with each plan.

Cost-Sharing Requirements

Medicare Part A and B both require cost-sharing, which means that beneficiaries must pay a portion of their medical expenses. The amount of cost-sharing required depends on the type of service being provided.

Premiums

Most people do not have to pay a premium for Part A coverage if they or their spouse have paid into the Social Security system for at least 10 years. There is a monthly premium for Part B coverage, which is based on income.

Deductibles

Part A and B both have deductibles that must be met before benefits become available. The amount of the deductible varies depending on the type of service being provided.

Co-insurance

Part A and B both require co-insurance, which is an amount that the beneficiary must pay after the deductible has been met. The amount of co-insurance varies depending on the type of service being provided.

Breakdown of Medicare Parts A and B

To summarize, here is a breakdown of what Medicare Part A and B cover:

Part A: Inpatient Care

Part A covers inpatient hospital care, skilled nursing facility care, home health care, hospice care, and some types of durable medical equipment.

Part B: Outpatient Care

Part B covers physician services, outpatient care, preventive services, laboratory services, and ambulance services.

Conclusion

We hope this article has helped you better understand what Medicare Part A and B cover. Medicare Part A and B provide a wide range of benefits to those who are eligible for them. In order to make sure you understand the cost-sharing requirements, premiums, deductibles, and co-insurance associated with each plan, it is important to speak with your insurance provider.