Understanding Original Medicare
Original Medicare consists of two main parts: Medicare Part A and Medicare Part B. While these parts cover a broad range of healthcare services, it’s essential to understand what they do not cover. Knowing this can help you plan better for your healthcare needs and avoid unexpected costs.
The Basics of Medicare Part A and B
Medicare Part A is known as hospital insurance. It generally covers inpatient care in hospitals, skilled nursing facility care, hospice care, and some home health care. Medicare Part B, on the other hand, is medical insurance which covers services like doctor visits, outpatient care, home health services, and some preventive services.
However, there are significant services and items that these parts do not cover. Let’s explore them further.
What Medicare Part A and Part B Do Not Cover
- Prescription Drugs: Original Medicare does not cover most prescription drugs. To get coverage for medications, you would need to enroll in a Medicare Part D prescription drug plan.
- Routine Dental Care: Services such as cleanings, fillings, and dentures are not covered by Part A and Part B.
- Vision Care: While medically necessary eye exams are covered, routine eye exams and glasses are not.
- Hearing Aids: Hearing exams and hearing aids are generally not included in Original Medicare coverage.
- Long-term Care: Extended stays in nursing homes or custodial care are not covered unless they’re part of care received in a skilled nursing facility post-hospitalization.
- Cosmetic Surgery: Procedures intended to improve appearance are not covered unless medically necessary due to injury or to improve the function of a malformed body part.
Additional Costs Not Covered by Medicare Part A and Part B
Even for services that are covered, you’ll have to pay certain out-of-pocket costs, including:
- Deductibles: The amount you pay before your Medicare coverage starts paying.
- Copayments and Coinsurance: Your share of the costs of a covered healthcare service, usually a percentage of the allowed amount for the service.
- Part B Premium: A monthly premium you pay for Medicare Part B.
Exploring Medicare Advantage and Supplement Plans
Many people choose to enhance their coverage by enrolling in Medicare Advantage Plans (Part C) or Medicare Supplement Plans. Medicare Advantage Plans often include additional benefits such as prescription drug coverage, vision, dental, and more.
Medicare Supplement Plans can help cover some of the out-of-pocket costs not covered by Original Medicare. These plans can be a wise choice if you want more predictable healthcare costs.
Who Is Eligible for Medicare?
Generally, you become eligible for Medicare when you turn 65, but some younger people with disabilities or specific conditions may also qualify. Once eligible, you can sign up for Part A and Part B through the Social Security Administration.
The Importance of Understanding Your Medicare Coverage
Understanding what Medicare Part A and Part B do not cover is crucial in avoiding unexpected medical expenses. By exploring additional Medicare Plans like Part D, Medicare Advantage, or Supplement plans, you can ensure comprehensive healthcare coverage.
We’re Here to Help
If you’re feeling overwhelmed by the options, don’t worry. Think 65 in Colorado Springs is here to help. Our knowledgeable team can guide you through your choices to find the best plan for your needs. Don’t let confusion stop you from getting the coverage you need. Call us today at (719) 301-1220 to speak with one of our friendly agents.