Health Care: What’s Covered by Medicare?

Medicare provides essential healthcare coverage for millions of Americans, but knowing exactly what is covered can help you plan better and avoid unexpected expenses. Whether you’re new to Medicare or reviewing your options, here’s a clear breakdown of the healthcare services Medicare covers.

Hospital Coverage (Part A)

Medicare Part A helps cover:

• Inpatient hospital stays (semi-private room, meals, nursing care)

• Skilled nursing facility care (after a qualifying hospital stay)

• Hospice care for terminally ill patients

• Home health care services (limited, medically necessary)

✅ Most people get Part A premium-free if they paid Medicare taxes while working.

Medical Coverage (Part B)

Medicare Part B covers:

• Doctor visits (primary care and specialists)

• Outpatient care (surgeries, diagnostic tests)

• Preventive services (annual wellness visits, screenings, vaccines)

• Mental health services (therapy, psychiatric care)

• Durable medical equipment (wheelchairs, oxygen equipment)

✅ Part B requires a monthly premium, typically deducted from your Social Security benefits.

Prescription Drug Coverage (Part D)

Part D helps pay for:

• Prescription medications

• Vaccines not covered by Part B

✅ You must enroll separately in a Part D plan or choose a Medicare Advantage plan that includes drug coverage.

Medicare Advantage Plans (Part C)

Medicare Advantage plans are offered by private insurers and must cover everything that Original Medicare covers, plus many offer extras like:

• Routine dental, vision, and hearing services

• Fitness programs (like SilverSneakers)

• Over-the-counter allowances for medications and health items

✅ Plans vary by provider and location, so it’s important to compare carefully.

What’s NOT Covered by Medicare?

Medicare doesn’t cover everything. Services typically not covered include:

• Routine dental care (cleanings, fillings, dentures)

• Vision care (routine eye exams, glasses)

• Hearing aids and exams for fitting

• Long-term custodial care (like assisted living)

• Cosmetic surgery

• Medical care outside the U.S. (with few exceptions)

  
  

To fill these gaps, many people add:

• Medigap (Medicare Supplement) insurance

• Medicare Advantage plans

• Standalone dental, vision, or hearing insurance

  
  

Final Thoughts

Medicare provides a strong foundation for healthcare coverage, but understanding what is and isn’t covered helps you plan wisely. Supplemental insurance options can help you get more complete protection for your health and finances.

Need help finding the right Medicare coverage?Lindbergh and Associates is here to guide you every step of the way!

📞 Call us today or schedule a free consultation to maximize your Medicare benefits.