What Medicare Does and Doesn’t Cover

Medicare is a federal health insurance program primarily for individuals aged 65 and older, though it also covers certain younger people with disabilities. Understanding what the various types of Medicare may or may not cover can help policyholders make informed decisions about their health care needs.

Medicare Parts Overview

When considering your coverage needs and options, familiarize yourself with how Medicare’s four parts operate:

• Part A (hospital insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. Many people do not pay a premium for Part A if they or their spouse paid Medicare taxes while working.

• Part B (medical insurance) covers certain doctors’ services, outpatient care, medical supplies and preventive services. Part B requires a monthly premium, which varies based on income.

• Part C (Medicare Advantage) is an alternative to Original Medicare (Parts A and B). Private companies approved by Medicare offer these plans, often including additional benefits such as vision, hearing and dental coverage. Medicare Advantage plans usually include Part D (prescription drug coverage) as well.

• Part D (prescription drug coverage) can help cover the cost of prescription drugs. It is available through Medicare-approved private insurers and can be added to Original Medicare or included in a Medicare Advantage plan.

How to Make Coverage Selections

To assess their coverage needs, policyholders should consider their current health status, frequency of doctor visits, prescription drug requirements, and budget. Tools like health needs assessments can help identify gaps in coverage and determine whether additional policies, such as Medigap (Medicare Supplement Insurance), are necessary.

When selecting the right policies, it’s important to compare the benefits, costs, and network restrictions of different plans. Consulting with a Medicare advisor or using resources like the Medicare Plan Finder can provide personalized guidance. Additionally, policyholders should review their coverage annually during the open enrollment period to ensure it continues to meet their needs.

We’re Here to Help

Contact Medicareline Insurance in Colorado Springs, Colorado, to learn more about coverage options and select the right plan.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.