Medicare Basics
Basic Information
Medicare Has Four Parts
- Part A - Hospital insurance
- Part B - Medical insurance
- Part C - Medicare Advantage Plans like HMOs (health maintenance organizations) and PPOs (preferred provider organizations)
- Part D - Medicare prescription drug coverage
Medicare Part A helps cover inpatient care in hospitals. Part A also helps cover skilled nursing facility care, hospice care, and home health care, under certain conditions.
Medicare Part B helps cover medical services such as doctor's services, outpatient care, and other medical services that Part A doesn't cover. Part B also covers some preventive services, such as flu shots and diabetes screening, to help people maintain their health and to keep certain illnesses from getting worse.
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Medicare Advantage Plans, sometimes known as Medicare Part C, are health plans people can join to get their Medicare benefits. These plans cover hospital costs (Part A), medical costs (Part B), and sometimes prescription drug costs (Part D). Medicare Advantage Plans may also offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Medicare Advantage Plans are managed by private insurance companies approved by Medicare.
Medicare Part D helps pay for medications that a doctor may prescribe. This coverage may help lower prescription drug costs. These plans are run by insurance companies and other private companies approved by Medicare.
For more information about Medicare Parts A, B, C, and D, visit http://www.medicare.gov and view or print a copy of "Your Medicare Benefits" or "Medicare & You." (Under "Search Tools," select "Find a Medicare Publication.")
What Medicare Doesn’t Cover
Medicare doesn't cover everything. For example, Medicare doesn't cover cosmetic surgery, health care you get while traveling outside of the United States (except in limited cases), hearing aids, most hearing exams, long-term care (like care in a nursing home), most eyeglasses, most dental care and dentures, and more. Some of these services may be covered by a Medicare Advantage Plan.
Medicaid
Some people think that Medicare and Medicaid are the same, but they are two different programs. Medicaid is a state-run program that provides hospital and medical coverage for people with low income and little or no resources. Each state has its own rules about who is eligible and what is covered under Medicaid. Some people qualify for both Medicare and Medicaid.
If you have questions about Medicaid, you can call your State Medical Assistance (Medicaid) office for more information. Visit http://www.medicare.gov on the web. (Under "Search Tools," select "Find Helpful Phone Numbers and Websites.") Or, call 1-800-Medicare (1-800-633-4227) to get the telephone number. TTY users should call 1-877-486-2048.
