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.
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)
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).
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)
What does Original Medicare NOT cover?
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.
