Medicare Coverage Guide: What's Covered for Seniors
Understanding what Medicare covers can save money and ensure proper care. Learn about Parts A, B, C, and D and what they mean for your family.
Medicare is the primary health insurance for most Americans over 65. Understanding its coverage helps you make informed healthcare decisions and avoid unexpected costs.
Medicare Part A: Hospital Insurance
What's Covered
- Inpatient hospital stays
- Skilled nursing facility care (limited)
- Hospice care
- Some home health care
Costs
- Most people don't pay a premium (paid through payroll taxes)
- Hospital deductible: $1,632 per benefit period (2024)
- Skilled nursing: Days 1-20 free, Days 21-100 have coinsurance
Medicare Part B: Medical Insurance
What's Covered
- Doctor visits
- Outpatient care
- Preventive services (many free)
- Medical equipment
- Mental health services
- Some home health care
Costs
- Standard premium: $174.70/month (2024)
- Higher incomes pay more (IRMAA)
- Annual deductible: $240
- 20% coinsurance for most services
Medicare Part C: Medicare Advantage
Private insurance plans that include Parts A and B, often with added benefits:
- Usually include prescription drug coverage
- May offer dental, vision, hearing
- Often have lower out-of-pocket costs
- Require using network providers
Medicare Part D: Prescription Drug Coverage
- Covers prescription medications
- Available through private insurers
- Plans and coverage vary
- Important to compare formularies
What Medicare DOESN'T Cover
- Long-term custodial care: Daily assistance with ADLs
- Most dental care: Routine cleanings, fillings, dentures
- Eye exams for glasses: Routine vision care
- Hearing aids: Not covered under traditional Medicare
- Care outside the US: With few exceptions
Supplemental Coverage Options
- Medigap: Helps cover Part A and B cost-sharing
- Medicaid: For low-income seniors (covers what Medicare doesn't)
- Employer coverage: May supplement Medicare
Review coverage options annually during Open Enrollment (October 15 - December 7) to ensure you have the best plan for your needs.