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What is Medicare and What Does it Cover?

Medicare is the federal health insurance program for people who are 65 or older, or those under 65 who may qualify because of a disability or another special situation. Medicare helps millions of American seniors and disabled individuals cover some of their health care costs.

Medicare also offers important choices in how you receive benefits – whether through the federal government and Original Medicare (Parts A & B) or through a Medicare-approved private insurer that offers additional benefits like prescription drug coverage (Medicare Advantage plans (Part C) and Medicare Part D drug coverage plans).

The different parts of Medicare help cover the costs of specific services.

 
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What Do Medicare Parts A and B (Original Medicare) Cover?

Medicare Parts A & B, often called Original Medicare, are the two component parts of the federal health insurance program for people 65 years of age or older. This health insurance program is also available to younger people who qualify based on specific, existing health conditions.  

What Does Medicare Part A Cover?

Medicare Part A is hospital insurance that covers certain expenses incurred during an inpatient hospital stay. This includes things like your room fees, meals, operating room, and rehabilitation services as well as lab tests and X-rays. Medicare Part A also covers necessary medical supplies and drugs that are administered during your hospital stay. However, it does not cover the fees of doctors associated with your care while you are in the hospital. Medicare Part A also does not cover hospital fees considered medically unnecessary, such as private duty nursing, the television or telephone in your room (if there are separate charges for these), or personal care items such as razors and slippers.

What Does Medicare Part B Cover?

Medicare Part B covers medically necessary outpatient services such as routine doctor visits, many emergency medical services, outpatient mental health services and some preventive care measures, such as flu shots. Medicare Part B also covers the equipment and tests administered during these outpatient services. Like Medicare Part A, Medicare Part B covers some medication administered during your visit but not drugs you are prescribed to take after the visit is complete.


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