What Does Medicare Cover? Understanding Coverage

Confused about Medicare Coverage? Overwhelmed with all the information you’re receiving? You’re not alone. Medicare coverage can be confusing, especially if you’re not familiar with the different types of coverage and eligibility requirements.

In a nutshell, Medicare generally covers about 80% of your Medical Cost. This leaves you with 20% of the costs to pay out of your pocket. However, there are many different types of coverage that contribute to your Medicare coverage as a whole. Here is a breakdown of the different kinds of coverage Medicare can offer, and how we can help you find a plan that works for you.

Part A: Hospital Coverage

Part A of Medicare generally covers: Hospital, Hospice, Home Health Care, Skilled Nursing Care and Nursing Home Care.

According to HHS.gov, to be eligible for Part A of Medicare, premium-free, you must be age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. It may be possible to receive Medicare Part A at age 65 without having to pay premiums if:

• You receive retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
• Your spouse of you had Medicare-covered government employment.
• If you are 65 or older and a citizen or permanent resident of the United States, but you and your spouse did not pay Medicare taxes while working, you may be able to buy Medicare Part A.

Part B: Medical Coverage

Medicare Part B generally covers: Doctor and Specialist Visits, Lab Tests, Mental Health Care, Ambulance, Preventative Services, Wheelchairs, Walkers, Oxygen, and Outpatient Hospital.

Medicare Part B is not free for anyone. However, the monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.
If you are not receiving the aforementioned benefits, you will be billed every three months for your premium of Medicare Part B.

Part C: Medicare Advantage

Overall, Part C is a combination of the Medicare Parts A & B, plus additional benefits and services provided by a private insurance company. Medicare Advantage provides benefits in one cohesive plan. It’s important to note that included in all types of Medicare Advantage Plans, is coverage for emergency and urgently needed care, according to medicare.gov.These benefits include and are not limited to:

• Flat Rate or $0 Copays for Services
• In bedded Part D Prescription coverage
• Dental and Vision coverage
• Hearing Aid coverage
• Gym Memberships

Plan coverage, benefits and services vary by insurance company and in certain areas of the country. Plans may be as low as $0 per month. If you’re unsure what you are qualified to receive, feel free to reach out to one of our expert insurance agents today!

Part D: Prescription Drugs

Part D covers prescription drugs. You can get Part D prescription drugs coverage two ways:

1. Voluntary enrollment in a stand-alone Medicare Part D plan OR
2. Enrollment in Part C (Medicare Advantage) plan that offers Part D prescription drug coverage.
   Medicare Supplement (MediGap)

Generally speaking, Medicare Supplement plans will fill some gaps that certain Medicare benefits do not cover. MediGap has no provider networks, which means that you are free to see any doctor in the nation that accepts Medicare. However, these plans all have a monthly premium. They typically do not have additional benefits such as: Dental, Vision, Hearing or prescription coverage.
If you still aren’t sure whether or not you’re eligible for Medicare, you can check on the eligibility calculator that is provided by www.medicare.gov.

At Accurate Choice Insurance, we care about matching a health insurance plan that specifically fits your eligibility, needs and lifestyle. There is no “one size fits all” Health Insurance plan anymore. That’s why Accurate Choice Insurance is here to help. If you have questions or would like to learn more about coverage options, contact us at info@accuratechoiceins.com or 702-425-4100!