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Medicare is a federal health insurance program that pays for a variety of health care expenses. It is available for people age 65 and older, or for those who are under age 65 and either on Social Security Disability Income (SSDI) or diagnosed with certain diseases such as End-Stage Renal Disease (ESRD) and Lou Gehrig’s Disease (Amyotrophic Lateral Sclerosis or ALS).
In general, Medicare covers services (such as doctor visits, lab tests, and surgeries) as well as supplies (like wheelchairs or walkers) that are considered medically necessary to treat a disease or condition.

Medicare Part A

In general, Medicare Part A covers:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care, as long as custodial care (assistance bathing and dressing) isn’t the only care needed
  • Hospice
  • Home health services

Medicare Part B

Medicare Part B covers 2 main types of services:

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition.
  • Preventive services: Health care to prevent illness or detect it at an early stage.

Part B coverage includes things such as ambulance services, clinical research and lab testing, immunizations (such as the flu shot), and durable medical equipment.

Medigap

medicare supplement

A Medigap plan is a supplemental insurance plan provided by a private insurance company, designed to help fill the “gaps” that Medicare does not cover, such as co-insurance and copay costs. There are multiple federally standardized Medigap plans, and each one offers a different level of coverage.

Medicare Advantage (Medicare Part C)

A Medicare Advantage plan is an “all-in-one” insurance plan offered by a private insurance company. It includes all of the same benefits covered by Original Medicare Parts A and B, plus many plans also offer additional benefits, such as higher levels of coverage, and coverage for prescription drugs.

medicare part c

Medicare Part D

A Medicare Part D plan is an optional plan offered by a private insurance company to help cover the costs of prescription drugs. Each plan is different and may cover different prescription drugs, so it is important to ensure that the plan you choose (if you decide to get Part D coverage) includes coverage for your medications.

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