Orginal Medicare
PART A (HOSPITAL)
Medicare Part A is often called “hospital insurance.” It helps cover your care when you’re admitted to a hospital, a skilled nursing facility, or need certain home health or hospice services.
Here’s what it includes:
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Hospital stays: It covers your room, meals, nursing care, and some hospital services and supplies.
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Skilled nursing facility care: After a hospital stay, if you need rehab (like physical therapy) in a nursing facility, Part A helps with that too.
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Home health care: If your doctor says you need care at home (like therapy or nursing), Part A may cover it.
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Hospice care: If you have a terminal illness, Part A covers hospice services to keep you comfortable.
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What Medicare Part A Does NOT Cover
While Medicare Part A helps with hospital care, it doesn’t cover everything you might need. Here’s what it does not pay for:
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Doctor visits (even if you’re in the hospital — that’s usually Part B)
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Outpatient care (like specialist visits, lab tests, or X-rays outside a hospital stay)
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Prescription drugs you take at home (you need Part D or other drug coverage for that)
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Long-term care (like assisted living or a nursing home if you just need help with daily activities)
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Personal items (TV, phone, personal care items in the hospital)
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Private-duty nursing (special nurses for your personal care)
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What does Original Medicare NOT cover?
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What does Medicare not cover? Plenty! Medicare on its own does not cover prescription drugs that would be filled at a pharmacy. It does not cover things like dental, vision, or hearing. Believe it or not, Medicare does not cover a traditional physical after you have been on Medicare longer than 12 months. Medicare provides you with a “Welcome to Medicare” physical in the first year of being a Medicare recipient, but after that never again. Medicare covers what is known as a Wellness visit, but it is best described as a less detailed physical.
PART B (MEDICAL)
Medicare Part B is often called “medical insurance.” It helps pay for the everyday healthcare services you need to stay healthy or treat illnesses.
Here’s what Part B covers:
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Doctor visits: Whether you see your primary doctor or a specialist (like a heart doctor), Part B helps cover the cost.
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Outpatient care: If you get care without being admitted to the hospital (like surgery at an outpatient center), Part B covers it.
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Preventive services: Part B covers many routine screenings and shots to help you stay healthy, like:
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Flu shots
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Cancer screenings (mammograms, colonoscopies)
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Diabetes screenings
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Annual “Wellness” visits and more
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Durable medical equipment (DME): Things like wheelchairs, walkers, oxygen equipment — Part B helps pay for these if medically necessary.
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Lab tests and imaging: Blood work, X-rays, MRIs, CT scans — these are usually covered.
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Mental health services: Counseling, psychiatric visits, and depression screenings.
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Emergency room visits (if you’re not admitted to the hospital afterward).
How Part B Works:
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You usually pay a monthly premium for Part B.
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You also pay a deductible each year, then Medicare generally covers 80% of approved services — you pay the remaining 20% (unless you have other coverage like a supplement).
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What Part B Does Not Cover:
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Prescription drugs you take at home (you need Part D for that)
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Most dental care, vision, and hearing services (unless you add extra coverage)
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Long-term care (nursing home help if it’s just for personal needs)
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