What is Covered With Medicare Part A and Part B

Medicare Part A: Hospital Insurance

• Coverage:

• Inpatient hospital care: This includes semi-private rooms, meals, general nursing, and other hospital services and supplies.

• Skilled nursing facility care: Medicare covers a certain amount of days in a skilled nursing facility after a qualifying hospital stay.

• Hospice care: Provided to individuals who are terminally ill, Medicare covers hospice care for those with a life expectancy of six months or less.

• Home health care: Limited coverage for skilled nursing care, physical therapy, speech-language pathology services, and occupational therapy, among others, provided at home.
  

• Premium: Most people do not pay a premium for Medicare Part A if they or their spouse paid Medicare taxes while working.
  

• Deductible and Coinsurance:

• Hospital Stay: Medicare has a deductible for each benefit period. For example, in 2024, the deductible for inpatient hospital care is $1,556 per benefit period.

• Coinsurance: After the deductible, Medicare covers a portion of the costs, and the beneficiary is responsible for any remaining coinsurance amounts.
  

Medicare Part B: Medical Insurance

• Coverage:
  

• Doctor services: Includes visits to doctors and other health care providers.

• Outpatient care: Covers services received in a hospital outpatient department or in a doctor's office that don't require an overnight stay.

• Medical supplies: Includes durable medical equipment (such as wheelchairs or walkers), prosthetic devices, and some home health services and supplies.

• Preventive services: Covers certain screenings, vaccinations, and counseling to prevent illness or detect it at an early stage.

• Premium: Most beneficiaries pay a monthly premium for Medicare Part B. The premium amount can vary depending on income.
  

• Deductible and Coinsurance:

• Annual Deductible: In 2024, the Medicare Part B deductible is $240 per year.

• Coinsurance: After meeting the deductible, Medicare typically covers 80% of the Medicare-approved amount for covered services, and the beneficiary is responsible for the remaining 20%.
  

It's important for beneficiaries to understand their Medicare coverage and any out-of-pocket costs associated with it. Additionally, there may be other factors to consider, such as coverage limitations, eligibility criteria, and enrollment periods.