Part B covers outpatient services including some providers' services while inpatient at a hospital, outpatient hospital charges, most provider office visits even if the office is 'in a hospital', durable medical equipment, and most professionally administered prescription drugs.Part A covers hospital (inpatient, formally admitted only), skilled nursing (only after being formally admitted to a hospital for three days and not for custodial care), home health care, and hospice services.The specific details on these four Parts are as follows:

Additionally, Part C is an alternative that allows patients to choose their own plans with different benefit structures and that provide the same services as Parts A and B, almost always with additional benefits. Part D covers self-administered prescription drugs. Part A covers hospital, skilled nursing, and hospice services. Medicare is divided into four Parts: A, B, C and D. These additional costs can include but are not limited to Medicare Part A, B and D deductibles and Part B and C co-pays the costs of long-term custodial care (which Medicare does not consider health care) the cost of annual physical exams (for those not on Part C health plans almost all of which include physicals) and the costs related to basic Medicare's lifetime and per-incident limits. No matter which of those supplemental options the beneficiaries choose-private insurance or public health plans-to make up for the shortfall of what Medicare covers (or if they choose to do nothing), beneficiaries also have other healthcare-related costs. Households that retired in 2013 paid only 13 to 41 percent of the benefit dollars they are expected to receive. Treasury and the rest primarily from the Part A Trust Fund (which is funded by payroll taxes) and premiums paid by beneficiaries. In 2022, spending by the Medicare Trustees topped $900 billion per the Trustees report Table II.B.1, of which $423 billion came from the U.S. Enrollees almost always cover most of the remaining costs by taking additional private insurance and/or by joining a public Medicare Part C and/or Medicare Part D health plan. According to annual Medicare Trustees reports and research by Congress' MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. In 2022, according to the 2023 Medicare Trustees Report, Medicare provided health insurance for 65.0 million individuals-more than 57 million people aged 65 and older and about 8 million younger people.

It primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status as determined by the SSA, including people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). Medicare is a government national health insurance program in the United States, begun in 1965 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). These companies decide whether something is medically necessary and should be covered in their area.Centers for Medicare and Medicaid Services logo Local coverage decisions made by companies in each state that process claims for Medicare.National coverage decisions made by Medicare about whether something is covered.Medicare coverage is based on 3 main factors Find out if Medicare covers your item, service, or supply.The notice says that you may have to pay for the item, service, or supply. If so, you'll have to read and sign a notice. You may need something that's usually covered but your provider thinks that Medicare won't cover it in your situation. Talk to your doctor or other health care provider about why you need certain services or supplies.Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)Ģ ways to find out if Medicare covers what you need.Some services may only be covered in certain facilities or for patients with certain conditions. But, your plan must give you at least the same coverage as Original Medicare. If you're in a Medicare Advantage Plan or other Medicare plan, your plan may have different rules.

Medicare part abcd chart