What Does Medicare Cover? It Depends on the Plan You Choose

After sifting through mountains of paperwork, many Medicare applicants are left wondering, "What does Medicare cover?" Medicare provides a basic level of health insurance coverage for many disabled and retired individuals, but it is far from comprehensive. Many expenses must be partially or completely paid by the Medicare recipient, especially those which are not deemed medically necessary. Medicare coverage also depends on the plan chosen; individuals who enroll in Part D coverage, for instance, receive significant benefits toward their prescription drug expenses that are not covered by Medicare Part A and B insurance.

What does Medicare cover? Part A coverage provides a basic level of catastrophic medical care, including hospital stays, care at a skilled nursing facility or nursing home, and hospice care for those whose medical conditions are considered terminal. However, hospital stays must be of three days duration or longer, and a lifetime maximum applies to the number of days covered. Limitations on nursing home stay coverage are also in place. Part B coverage provides a basic level of preventive services, including testing for a number of common ailments and health care supplies. For instance, diabetic supplies and prosthetics are covered under Part B, along with medically necessary chiropractic care. Routine physical examinations are usually not covered, but continuing care for an ongoing physical malady is generally included in Part B coverage. Medicare Part D provides benefits for prescription drugs, allowing members to save on their medications by paying a small monthly premium.

Medicare Part C plans combine the attributes of Part A, Part B, and in many cases Part D coverage in commercial plans offered by a variety of private companies. Many of these offer better benefits than basic Medicare plans, but may require members to obtain care through their preferred provider network in order to control costs. Part C participants must pay a monthly premium, which varies significantly depending on the services included, the company providing the services, and the age of the Medicare recipient. So, what does Medicare cover? The answer depends on the plan chosen and the company that provides the coverage.