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Medicare Overview


Medicare provides protection against the costs of many health care services, but traditional Medicare has relatively high deductibles and cost-sharing requirements and places no limit on beneficiaries out-of-pocket spending for services covered under Parts A and B.

Medicare does not pay for some services that are important for older people and people with disabilities, including long-term services and supports, dental services, eyeglasses, and hearing aids.

The Medicare program consists of four different parts which are A, B, C, and D

Part A covers inpatient hospital stays, skilled nursing facility stays, some home health visits, and hospice care. Part A benefits are subject to a deductible. Beneficiaries are subject to coinsurance amounts for extended inpatient stays in a hospital or skilled nursing facility.

Part B covers physician visits, outpatient services, preventive services, and some home health visits. Part B benefits are subject to a deductible, and most Part B benefits are subject to coinsurance of 20 percent. No coinsurance or deductible is charged for an annual wellness visit or for preventive services that are rated A or B by the U.S. Preventive Services Task Force.

Part C refers to the Medicare Advantage program through which beneficiaries can enroll in a private health plan, such as a health maintenance organization (HMO) or preferred provider organization (PPO), and receive all Medicare-covered Part A and Part B benefits and typically Part D benefits.

Part D covers outpatient prescription drugs through private plans that contract with Medicare, including both stand-alone prescription drug plans and Medicare Advantage drug plans. Enrollment in Part D plans is voluntary. The benefit helps pay for enrollees drug costs after a deductible is met, and offers catastrophic coverage for very high drug costs. Enrollees pay monthly premiums and cost sharing for

prescriptions which vary by plan.

#OriginalMedicare

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