Parts A & B in a Nutshell

As insurance agents, dispelling confusion about Medicare is one of the things we love most about our work. But, researching insurance can sometimes feel like going to the big box store for milk, and walking out with a cart-load of groceries. All you probably want are the facts, just the facts, delivered calmly and quickly.

So here you go: Medicare Parts A & B, in a nutshell.

In general, Part A coverage includes:

• Inpatient hospital care

• Skilled nursing facility care

• Inpatient care in a skilled nursing facility that is not custodial or long-term

• Hospice care

• Health care at home

Part B covers 2 types of services

• Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.

• Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

Part B covers things like:

• Clinical research  

• Ambulance services

• Durable medical equipment (DME)

• Mental health

  • Inpatient

  • Outpatient

  • Partial hospitalization

• Getting a second opinion before surgery

• Limited outpatient prescription drugs

2 ways to find out if Medicare covers what you need

1. Talk to your doctor, insurance agent or other health care provider about why you need certain services or supplies.

2. Find out if Medicare covers your item, service, or supply.