Sometimes people find it easier to understand what is included in something when you understand what is NOT included. If this is you then please read on.
Medicare is a public health insurance option available to those 65 and older and some disabled Americans. Founded in 1965, today Medicare covers 44 million people.
The coverage Medicare offers is wide-ranging. The government provides much of it in Original Medicare. For those who want additional benefits, Parts C and D can provide what you need.
Curious about whether Medicare covers something or if you need another option? Here’s what you need to know.
The Four Parts of Medicare
When people talk about what’s covered by Medicare, they’re often only talking about Original Medicare, which is made up of Part A and Part B.
However, there are actually four parts of Medicare. The federal government provides Part A and Part B, while private insurance companies offer Part C and Part D.
Medicare Part A covers inpatient hospitalization and care, including inpatient prescription medication. Part A is free to most Americans.
Part B covers other types of medical services, including doctor visits and outpatient procedures. Together Part A and Part B comprise Original Medicare.
Part C is known as Medicare Advantage and is provided by private insurance companies. This Medicare alternative includes a lot of extra benefits, including coverage of prescription medications.
Part D is prescription drug coverage alone. It is also provided by private companies, and many seniors use this coverage along with Original Medicare.
What Original Medicare Doesn’t Cover
When people discuss what Medicare doesn’t cover, they’re usually talking about Parts A and B, or Original Medicare. Original Medicare is designed to cover major medical services.
Some of the things not covered by Original Medicare include:
- Most dental care
- Vision care including glasses
- Prescription drugs
- Hearing aids
- Long-term care
You also have to pay copayments and deductibles when you receive medical services.
In the past Original Medicare didn’t cover alternative medicine, but starting in 2021, you can receive a limited number of acupuncture treatments performed by a licensed medical practitioner.
That doesn’t mean that seniors don’t have access to other benefits, however. Instead, you have to choose additional coverage, such as Part C (Medicare Advantage).
Using Medicare Parts C and D For Additional Coverage
Interested in going beyond Original Medicare? There are a lot of options, and they don’t have to cost a lot of money. In fact, there are Medicare Advantage plans that cost $0 beyond your normal Part B premium.
Medicare Part C, or an Advantage Plan, can give you coverage closely resembling private health insurance. Instead of 20% coinsurance for services, you may have a deductible or copayments.
Depending on your plan, you may also get vision and dental coverage, health club membership, and access to other care. Advantage plans generally include prescription drug coverage as well. However, you’ll probably have to stay in the provider network the insurer has.
Medicare Part D can allow you to use Original Medicare for major medical needs — with no concerns about a doctor’s network — but still receive coverage for prescription medication.
What’s Not Covered By Medicare?
Now you understand more about what’s not covered by Original Medicare. Medicare Parts A and B are designed to give you major medical coverage, which is why it doesn’t have other benefits. Fortunately, you can get those alternatives through Parts C or D.
If you need assistance navigating your choices with Medicare, we understand. We’re here to help you choose the coverage that’s right for you.