What Does Medicare Cover

Medicare covers a huge number of benefits for your healthcare. Your exact coverage will look different based on your needs—to find the coverage that works for you, call The Coleman Agency.

Original Medicare Coverage

With Part A, you will receive emergency medical care coverage. This coverage is absolutely vital to anyone’s complete wellbeing and safety, and is required before you can purchase/enroll in any other Medicare policy. It’s benefits include emergency hospital stays and healthcare and skilled nursing facility stays and healthcare, both up to 90 days total per year.

Some other benefits may be available depending on your needs, provider, location, etc. You may also receive:

  • General clinical/nursing care
  • Short-term nursing home care
  • Home healthcare

Part B makes up the other half of Original Medicare. Like Part A, you must also have Part B before you enroll in another Medicare plan. It covers general treatment, preventative, and diagnostic services and care, including:

  • Ambulance services
  • Durable medical equipment
  • Mental health services
  • X-rays and lab tests
  • Certain outpatient prescriptions
  • Provider services
  • Screenings and vaccines

Medicare Advantage Coverage

Medicare Part C, otherwise known as Medicare Advantage, is an all-in-one alternative to Original Medicare (Part A and Part B). It coordinates your healthcare by placing you within an established network to lower your overall out-of-pocket costs.

Part C, then, covers pre-existing costs more so than specific benefits. However, most plans provide prescription drug coverage, as well as limited dental, vision, and hearing checkups.

Medicare Part D Coverage

Medicare Part D covers prescription drugs. It can either be purchased alongside Parts A and B, or included in Medicare Advantage as previously mentioned.

Your coverage under Part D is categorized based on the type and expense of the drug itself. The smaller the cost of a prescription, the less you pay out-of-pocket. Regardless, however, drugs for almost every ailment are included. These price points are categorized into 4 tiers:

  • Tier 1—preferred generic prescriptions with the lowest copayment
  • Tier 2—preferred, brand-name prescription drugs with medium copayments
  • Tier 3—non-preferred, brand-name prescription drugs with higher copayments
  • Tier 4 (Specialty Tier)—high-cost prescription drugs with the highest copayment

Medigap Coverage

Medigap, or Medicare supplements, provide additional cost coverage and benefits to Original Medicare, reducing your overall out-of-pocket costs. There are 10 different Medicare Supplement plans—plans A, B, C, D, F, G, K, L, M, and N. Each of these plans have different coverage with different premiums. Coverage will vary among plans, but they may cover these costs:

  • Part A coinsurance & hospital costs
  • Part B coinsurance/copayment
  • Your first 3 pints of blood for transfusions
  • Part A hospice care coinsurance or copayment
  • Skilled nursing care facility coinsurance
  • Part A deductible
  • Part B deductible
  • Part B excess charges
  • 80% of foreign travel emergency care.

Find the Right Coverage for You—Call The Coleman Agency

No insurance agency is going to care for your peace-of-mind like The Coleman Agency. We are invested in our people, and will do what it takes to make sure they get the Medicare coverage they need to feel safe and secure. To learn more, give us a call.

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