What Does Medicare Cover?
If you’re eligible for Medicare and ready to explore your options, the first step is to get to know its four different parts. Each part represents a different kind of coverage.
Also called hospital insurance, Medicare Part A covers the cost if you are admitted to a hospital, skilled nursing facility, or hospice. It also covers some home health services. Most people are enrolled automatically in Part A when they reach age 65.
With Part A, you'll pay:
- A deductible each year. This is how much you have to spend before Medicare starts to pay its part.
- Coinsurance. This is the part of the costs for hospital care you may be required to pay after you've met your deductible.
If you or your spouse worked for 10 years or more in the U.S., you don't have to pay a monthly fee to have Part A.
If you or your spouse did not work at least 10 years in the U.S., you have to pay a monthly fee to have Part A. If you or your spouse worked less than 7.5 years in the U.S., you will have to pay a larger amount.
Together, Part A and Part B are called original Medicare or traditional Medicare.
Also called medical insurance, Part B covers outpatient care. For instance, it pays for your visits to a doctor’s office, tests, and preventive health care like cancer screenings and vaccines. Part B also covers some medical supplies, like blood sugar test strips, therapeutic shoes, and more. It’s common for people to be automatically enrolled in Part B, too.
For Medicare Part B, you pay:
- A monthly fee.
- A deductible, which is a set amount you pay each year before Part B starts paying for any of your care.
- Twenty percent of the Medicare-approved amount for some types of care. These are doctor's appointments, physical therapy, diabetes supplies, durable medical equipment like commode chairs, wheelchairs, and others. You have to meet your deductible before you start paying 20%.
If you see a doctor who has not signed an agreement to accept Medicare-approved amounts, you will pay more -- possibly up to the full cost -- for a doctor's visit and care.