What Do the Parts of Medicare Cover?

Get the coverage you need to live your best life.

Medicare Coverage

The different parts of Medicare help you pay for different health services. Get to know them to better to ensure you get everything you need in a Medicare health plan.

Part A Part B Part C Part D

Part A: Hospital Coverage

It also covers:

Inpatient care in hospitals
Skilled nursing
Hospice

For most people, Medicare Part A is free. If you don’t qualify for free Part A coverage, you can buy it. Contact your local Social Security office to find out how. Or, use Medicare’s eligibility tool to see if you’ll need to pay for Part A coverage.

Part B: Medical Coverage

It also covers:

Physical therapy
Mental health care
Annual wellness visit
Medical equipment, including wheelchairs and walkers
Lab services, such as blood work and X-rays
Preventive care, including flu shots, mammograms and screenings

There is a monthly cost for Part B coverage. The cost is set each year by Medicare and based on your yearly income. If you get Social Security, your monthly premium will come out of your Social Security check automatically.

Also, there are certain situations that let you delay enrolling in Medicare Part B to avoid having to pay the monthly premium.

Part C: Medicare Advantage

Medicare Advantage plans are available from healthcare companies like CareFirst BlueCross BlueShield. They cover all the benefits under Original Medicare.

Many include prescription drug coverage (Part D) as well as additional benefits, such as:

Dental
Vision
Hearing

Other things you should know:

You may have to visit doctors and hospitals within the plan network
Once enrolled, you’ll only need to use the plans ID card, but you should keep your Original Medicare card

Dual Special Needs Plan (DSNP)

A DSNP plan is a type of Medicare Advantage plan for those with both Medicare and Medicaid (Maryland Medical Assistance Program).

These plans focus on improving your health and combine the benefits of:

Medicare Part A
Medicare Part B
Medicare Part D
Medicaid

A DSNP plan can also include additional benefits like:

Dental
Vision
Hearing

Part D: Prescription Drug Coverage

To add a Part D plan, you must have either:

Part B, or
Medicare Advantage

Part D drug plans are available from private healthcare companies. They’re required to cover certain common types of drugs. However, each plan may choose which specific drugs it covers. Before purchasing a Part D plan, review each plan’s list of drugs (also called a formulary) to see if your drugs are on the list.

Medicare prescription drug plans do NOT cover:

Drugs not on the plan’s formulary
Drugs that Part A or Part B cover
Drugs excluded by Medicare

Explore More of the Basics

Original Medicare does not cover 100% of the costs of your health services. It covers about 80%.

Some of the services NOT covered by Original Medicare include:

Prescription drugs
Dental exams, most dental care or dentures
Routine eye exams, eyeglasses or contacts
Hearing aids or related exams or services
Most care while traveling outside the United States
Help with bathing, dressing, eating, etc. (custodial care)
Comfort items such as a hospital phone, TV or private room
Long-term care
Cosmetic surgery
Most chiropractic services
Acupuncture or other alternative treatments
Routine foot care

There’s no charge, so there’s no reason not to use it.

If you’ve had Medicare Part B for at least 12 months, your annual wellness visit is 100% covered. It’s not a physical, but your doctor will work with you to make a personalized plan for managing your health.

Some Medicare Advantage (Part C) plans may also cover an annual physical.