Medicare Parts A and B form the foundation of Medicare, often referred to as "Original Medicare." Understanding the benefits of Medicare Parts A and B can help you make informed decisions about your healthcare. Here’s a breakdown of the key benefits of Medicare Parts A and B, designed to give you peace of mind and ensure you get the care you need.
To help you navigate these options and find the best plan for your needs, we’ve teamed up with Chapter to provide personalized, 1-1 guidance.
Key Benefits of Part A: Hospital Insurance
Medicare Part A primarily covers inpatient hospital care, which is vital if you may require hospital stays due to various health conditions. These are the key benefits of Part A:
- Inpatient Hospital Care
- Medicare Part A primarily covers inpatient hospital care. This includes the costs associated with:
- Semi-private room
- Meals
- General Nursing
- Drugs
- Skilled Nursing Facility (SNF) Care
- Medicare Part A covers care in a skilled nursing facility following a qualifying hospital stay of at least three consecutive days. This coverage includes rehabilitation services such as physical and occupational therapy, which are crucial for recovery when full hospital services are not required. It's important to note that Medicare covers up to 100 days per benefit period, with the first 20 days fully covered and coinsurance costs applying for days 21 through 100.
- Hospice Care
- Medicare Part A provides coverage for hospice care for terminally ill patients who choose to focus on comfort rather than curative treatment. This includes a range of medical and support services, such as nursing care, pain management, and counseling, which can be provided at home or in a hospice facility. This ensures compassionate care without the added stress of financial concerns.
- Home Health Care
- While Medicare Part A can cover some home health services if you are homebound and need skilled nursing care or therapy services following a hospital or SNF stay, most home health care services are actually covered under Medicare Part B. This allows beneficiaries to receive necessary care in the comfort of their own home, offering convenience and comfort compared to a hospital stay.
- Cost
- Premium-free for most: Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years.
Key Benefits of Part B: Medical Insurance
Medicare Part B covers outpatient care and is essential for managing routine and preventive health needs. These are the key benefits of Part B:
- Doctor’s Visits
- Medicare Part B covers medically necessary services like doctor's visits, which include primary care as well as specialists. Whether you need routine check-ups or treatment for a specific condition, Part B ensures that you have access to medical professionals when you need them. Regular visits to your healthcare provider are essential for maintaining your health and managing any chronic conditions.
- Outpatient Care
- Part B covers a wide range of outpatient services, including:
- Laboratory tests
- X-rays and other diagnostic imaging
- Outpatient surgeries
- Emergency room visits
- Beneficiaries should be aware that there may be copayments for outpatient hospital services, and the exact amount can vary depending on the service provided.
- Preventive Services
- Medicare Part B emphasizes preventive care by covering various services, often at no cost when provided by a Medicare-approved provider. These include:
- Annual wellness visits
- Flu shots and other vaccinations
- Screenings for various types of cancer, cardiovascular disease, and other conditions
- Depression screenings
- Durable Medical Equipment (DME)
- If you need medical equipment such as wheelchairs, walkers, or oxygen equipment, Medicare Part B helps cover the costs. Beneficiaries typically pay 20% of the Medicare-approved amount for covered DME after meeting their deductible.
- Mental Health
- Part B covers various outpatient mental health care, including diagnosing and treating people with mental health conditions, like depression and anxiety.
- Ambulance Services
- In emergencies, Part B covers ambulance transportation to a hospital or skilled nursing facility.
To help you navigate these options and find the best plan for your needs, we’ve teamed up with Chapter to provide personalized, 1-1 guidance.
Your Path to Better Health with Medicare Parts A and B
Medicare Parts A and B offer comprehensive coverage that addresses both inpatient and outpatient needs, making them indispensable for older adults. Understanding these benefits can help beneficiaries manage their healthcare and make informed decisions about additional coverage options, such as Medigap or Medicare Advantage plans, to fill any gaps in coverage.
Ready to learn more about how Medicare Parts A and B can benefit you? Join our Medicare classes on GetSetUp to get a deeper understanding and navigate your healthcare with confidence.
Reviewed By: Keith Gilbert