Medicare Coverage: The Basics You Need to Know

If you’re turning 65 or qualifying for disability benefits, Medicare is likely on your radar. It can feel confusing, but the core idea is simple: Medicare helps pay for health care once you’re eligible. This guide breaks down what Medicare covers, how the parts work together, and a few easy ways to stretch your benefits.

What Each Medicare Part Covers

Part A – Hospital Insurance: This part handles inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people don’t pay a premium for Part A if they’ve paid enough Medicare taxes while working.

Part B – Medical Insurance: Part B picks up doctor visits, outpatient care, preventive services, and some medical supplies. You pay a monthly premium, and there’s a yearly deductible you’ll need to meet before Medicare starts covering the costs.

Part C – Medicare Advantage: Private insurers bundle Part A, Part B, and often Part D into one plan. These plans can add extra perks like vision, dental, or gym memberships. The trade‑off is you must use the plan’s network of doctors and hospitals.

Part D – Prescription Drug Coverage: This part helps cover the price of prescription medicines. You can add it to Original Medicare (Parts A and B) or get it through a Medicare Advantage plan that includes drug coverage.

Common Things Medicare Pays For

Medicare isn’t unlimited, but it does cover many everyday health needs. Expect coverage for:

• Hospital stays (Part A)
• Doctor appointments and outpatient procedures (Part B)
• Preventive screenings like mammograms and flu shots (Part B)
• Durable medical equipment such as walkers and oxygen (Part B)
• Prescription drugs (Part D)
• Skilled nursing care after a hospital discharge (Part A)

Things that usually aren’t covered include most dental work, hearing aids, long‑term care, and cosmetic surgery. If you need those services, you’ll have to look at supplemental plans or private insurance.

How to Save Money on Medicare

Even with coverage, out‑of‑pocket costs can add up. Here are three quick ways to keep costs down:

1. Choose the right plan: Compare the premiums, deductibles, and co‑pays of Medicare Advantage plans in your area. Some plans have lower drug costs but higher doctor visit fees, so match the plan to your usage.
2. Use preventive services: Medicare covers many screenings at no cost when you meet the guidelines. Getting these done early can prevent expensive treatments later.
3. Consider a Medigap policy: If you stick with Original Medicare, a supplemental (Medigap) plan can fill the gaps for hospital and medical costs, reducing surprises on your bills.

Another tip is to sign up during the Initial Enrollment Period. If you miss it, you may pay higher premiums or face a coverage gap.

Remember, Medicare rules can change year to year. Checking the annual “Medicare & You” handbook or using the official Medicare website helps you stay informed and avoid nasty surprises.

By understanding the four parts, knowing what services are covered, and taking a few cost‑saving steps, you can make Medicare work for you without breaking the bank.