What's happening with Medicare in Washington? Live Q&A with AARP expert 12/5 4:00 p.m. EST

Do you know how much your prescription drugs cost? Do you know there might be cheaper alternatives?

En español | Do you know the different parts that drive the Medicare program? Each part of Medicare covers different health services such as hospital care, doctor services and prescription drugs. AARP’s Medicare Question and Answer Tool is a starting point to guide you.

 

 

 

Medicare: Getting Started

 

Q: What are the different parts of Medicare?

A: There are different parts to Medicare: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage) and Part D (prescription drug coverage). — Read Full Answer

 

Q: What is Original Medicare?

A: The Original Medicare plan, also known as traditional Medicare, is a fee-for-service health plan. This means you can choose any doctor or hospital and Medicare will pay its share of the doctor or hospital bill. You pay a portion of the rest. Original Medicare pays for many health care services and supplies, but it doesn’t pay all of your health care costs. — Read Full Answer

 

Q: Does Original Medicare automatically include Part A, Part B and Part D?

A: You get Part A and Part B of the Original Medicare plan when you’re automatically signed up for Medicare. To get drug coverage under Original Medicare, you must choose and join a Medicare-approved Part D private drug plan. — Read Full Answer

 

 

 

Part A Hospital Insurance

 

Q: What is Medicare Part A?

A: Medicare Part A (hospital insurance) helps pay for inpatient hospital care and some other care, such as home health, hospice and skilled nursing facility care. — Read Full Answer

 

Q: What services are not covered by Medicare Part A?

A: Medicare Part A covers some of your hospital costs but not all. — Read Full Answer

 

 

 

Part B Medical Insurance

 

Q: What is Medicare Part B?

A: Medicare Part B (medical insurance) helps pay for doctor visits, some home health care, medical equipment, some preventive services, outpatient hospital care, rehabilitation therapy, laboratory tests, X-rays, mental health services, ambulance services and blood. — Read Full Answer

 

Q: What services are not covered by Medicare Part B?

A: Medicare Part B covers some of your hospital costs but not all. — Read Full Answer

 

 

 

Part D Prescription Drug Coverage

 

Q: What is Medicare Part D?

A: Medicare prescription drug coverage (Part D) is insurance that helps reduce the costs of prescription drugs. — Read Full Answer

 

Q: Are there different types of Medicare Part D plans?

A: In general, there are two kinds of Medicare prescription drug plans: “Stand alone” plans that offer only drug coverage. You can add this type of plan to Original Medicare and some types of Medicare Advantage plans that do not cover prescription drugs. The other kind is Medicare Advantage plans, where you generally can get both your Medicare health care and prescription drugs through one of these plans. — Read Full Answer

 

Q: How can I choose the best prescription drug plan for my needs?

A: First, make a list of the medications you are taking including their dosage, frequency and whether they are brand-name drugs or generics. — Read Full Answer

 

Q: Will I be able to sign up for more than one Medicare Part D prescription drug plan?

A: No. When you enroll in a new Medicare prescription drug plan, you are automatically disenrolled from your old plan. — Read Full Answer

 

Q: Do I have a choice of how I get my Medicare health and prescription drug coverage?

A: You can get Medicare through the Original Medicare plan or a Medicare Advantage plan (like an HMO or PPO). You can also choose a Medicare Part D plan that helps with prescription drug coverage. — Read Full Answer

 

Q: Does Medicare cover prescription drugs?

A: Medicare Part D drug plans help to pay for part of the cost of outpatient prescription drugs (those prescribed outside of a hospital stay). — Read Full Answer

 

Q: How do I know what drugs are covered through my Part D plan?

A: Your drug-plan sponsor will publish a list of the drugs it covers, known as a formulary. — Read Full Answer

 

Q: How can I find out whether the prescription medications I take are covered under different Medicare Part D plans?

A: The best way to find out what prescription drugs are covered on a plan’s formulary is to use Medicare’s Plan Finder tool. — Read Full Answer

 

Q: Do Medicare drug plans have preferred drug lists?

A: Yes, in Part D these lists are called “formularies,” and the amount you pay for each drug is based on the formulary tier to which a drug is assigned. — Read Full Answer

 

Q: What is a formulary?

A: A formulary is the list of drugs your plan covers. — Read Full Answer

 

Q: My Medicare drug plan won’t cover a drug that is on its list of covered drugs. Is there a reason why they are denying coverage?

A: There are a number of reasons why your plan may not cover a drug that is on its list of covered drugs (also called a formulary). — Read Full Answer

 

Q: Can I use my Medicare Part D drug plan all over the country?

A: Medicare drug plans set their own geographic boundaries for coverage; check your specific drug plan’s rules to determine whether you have coverage in other areas of the country. — Read Full Answer

 

Q: Is there a limit on the number of drugs a Medicare Part D plan will cover in a given year?

A: No, there is no limit on the number of total prescriptions a drug plan will cover in a given year. But, a plan can limit the amount of a particular type of medication you can get within a given time period. — Read Full Answer

 

 

 

What Medicare Does and Does Not Cover

 

Q: Does Medicare cover home health services?

A: Medicare covers some limited home health services. — Read Full Answer

 

Q: How do I find a Medicare-approved home health agency?

A: You can find a Medicare-approved home health agency in the Home Health Compare section of www.medicare.gov. — Read Full Answer

 

Q: Does Medicare pay for home health aides?

A: Medicare will cover limited home health services such as skilled nursing care or other therapy on a part-time or intermittent basis for people who are eligible for home health services. — Reading Full Answer

 

Q: Does Medicare cover hospice care?

A: Medicare pays for hospice care if you have a terminal illness and life expectancy of six months or less. — Read Full Answer

 

Q: Does Medicare pay for routine vision care?

A: Medicare will not generally pay for vision screening, eye exams for glasses or eyeglasses, but it will pay for diagnosis and treatment if you have a chronic eye condition, such as cataracts or glaucoma. — Read Full Answer

 

Q: Does Medicare cover routine dental care?

A: Generally, Medicare does not cover dentures or routine dental care that you need primarily for the health of your teeth. — Read Full Answer

 

Q: Does Medicare cover chiropractic services?

A: Medicare covers some chiropractic services. — Read Full Answer

 

Q: What medical supplies does Medicare cover?

A: Medicare does cover some medical supplies, but it depends on your medical condition. Visit www.medicare.gov and select “Your Medicare Coverage” or call 800-MEDICARE (800-633-4227) to learn more. — Read Full Answer

 

Q: Will Medicare pay for services to help me stop smoking?

A: Medicare covers some services if you use tobacco and you’ve been diagnosed with an illness caused or complicated by tobacco use, or you take a medicine that’s affected by tobacco. — Read Full Answer

 

Q: Does Medicare pay for the pneumonia shot?

A: Yes, Medicare Part B (medical insurance) pays for this shot. — Read Full Answer

 

Q: Does Original Medicare cover my flu shot? What if I have a Medicare Advantage plan?

A: Yes, Medicare Part B (medical insurance) covers 100 percent of the costs of one flu shot every flu season. If you have Original Medicare, you don’t have to meet your yearly Part B deductible before Medicare covers your flu shot. You also do not have a copayment as long as you see doctors or pharmacists who accept Medicare. — Read Full Answer

 

Q: Does Medicare cover the vaccine for shingles?

A: If you have Medicare Part D, the optional prescription drug benefit, your shingles vaccine should be covered but the process may be more complicated that filling a prescription for a medication. — Read Full Answer

 

Q: Will Medicare pay for a routine yearly physical examination?

A: No. However, Medicare does cover an annual wellness visit. — Read Full Answer

 

Q: What is the “Welcome to Medicare” wellness visit?

A: The "Welcome to Medicare" exam is a free one-time introductory wellness exam that is available to you during your first year of being enrolled in Medicare Part B. — Read Full Answer

 

Q: What is covered during the “Welcome to Medicare” wellness visit?

A: During this visit, your health care provider will give you a physical examination, evaluate your medical and family health history, make sure you are up to date on all preventive screenings and tests, and go over any medications you are taking. — Read Full Answer

 

Q: How can I prepare for my “Welcome to Medicare” visit?

A: Bring a list of your medical records, family health history and a list of the medications you take. — Read Full Answer

 

Q: I have a Medicare Advantage Plan. Can I still get the “Welcome to Medicare” visit?

A: Yes. The “Welcome to Medicare” preventive visit is available to people who are in Medicare Advantage Plans. Check with your plan to find out if the visit will be free for you. — Read Full Answer

 

Q: What is the annual wellness visit?

A: This is an annual visit to develop or update a prevention plan just for you, based on your health and risk factors. You’ll pay nothing for this benefit if the doctor participates in the Medicare program. — Read Full Answer

 

Q: If I have Medicare, can I get a colonoscopy with no cost to me?

A: Medicare covers several colorectal screening tests to help find precancerous growths in the colon so they can be removed before they turn into cancer. — Read Full Answer

 

Q: How can I find out more about a specific preventive service covered under Medicare?

A: For additional information, please visit the Preventive Services section of Medicare’s website www.medicare.gov. Or call Medicare directly at 800-MEDICARE (800-633-4227). — Read Full Answer

 

 

 


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