WHAT IS MEDICARE?
Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease and ALS (commonly known as Lou Gehrig’s disease. Unless you have insurance coverage from a current employer, you are required to enroll when you become eligible at 65 to avoid penalties.
What Medicare Does Cover
| PART A | PART B | PART D |
|---|---|---|
| Hospital care | Medically necessary doctor’s services and supplies and preventive care | |
| Skilled nursing facility care | Clinical research | |
| Inpatient care in a skilled nursing facility (not custodial or long-term care) | Ambulance services | Each Medicare prescription drug |
| Hospice (if you’re terminally ill) | Durable medical equipment | plan has its own list of covered drugs (called formulary). Many Medicare drug plans place drugs into different “tiers” on their formularies. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less than a drug in a higher tier. |
| Home health services | Mental health- Inpatient, Outpatient and Partial hospitalization | |
| Some lab tests | Some home health care | |
| Surgeries | Getting a second opinion before surgery | |
| Limited outpatient prescription drugs |
What Medicare Doesn’t Cover
| Many people are often surprised that Medicare does not offer vision or dental coverage. In addition, Medicare offers coverage only in the United States, which could be an issue for people considering vacationing or even retiring abroad. You’ll always want to verify whether a medical item or service is covered by Medicare. Below we’ve highlighted some of the most common items not covered by Original Medicare: | ||
|---|---|---|
| Long-term care (also called custodial care) | Acupuncture | |
| Routine dental care | Orthopedic shoes | Routine foot care (corns, bunions, etc.) |
| Routine eye care | Dentures | Care outside the United States |
| Cosmetic surgery | Hearing aids and related exams | |
