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The Driving Parts of Medicare

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 & A Home

 

Q: What are the different parts of Medicare?

A: Medicare has four parts, each offering a different type of coverage: 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: Original Medicare is a fee-for-service health program. This means that you can choose any doctor or hospital that accepts Medicare patients, anywhere in the United States, and Medicare will pay its share of the bill. — Read Full Answer

 

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

A: The original Medicare program consists of Part A and Part B. If you’re enrolled in original Medicare and want Part D prescription drug coverage, you must actively choose and join a Part D drug plan. But which type of insurance you choose, and when you enroll, depends on your own circumstances. — Read Full Answer

 

Q: Does Medicare cover prescription drugs?

A: Yes. Medicare has covered outpatient prescription drugs ever since the Part D drug benefit came into effect in 2006. — Read Full Answer

 

 

 

Part A Hospital Insurance Q & A Home

 

Q: What is Medicare Part A?

A: Medicare Part A helps pay for inpatient stays in the hospital or a short-term skilled nursing facility, for home health services and hospice care.  You don’t pay premiums for Part A if you or your spouse paid enough Medicare payroll taxes while working. — Read Full Answer

 

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

A: Medicare Part A covers many hospital costs but not all. — Read Full Answer

 

 

 

Part B Medical Insurance Q & A Home

 

Q: What is Medicare Part B?

A: Medicare Part B covers doctors’ services, outpatient care, and medical equipment and supplies. — Read Full Answer

 

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

A: Medicare Part B covers a very wide range of medical services, but there are gaps. — Read Full Answer

 

 

 

Part D Prescription Drug Coverage Q & A Home

 

Q: What is Medicare Part D?

A: Part D is insurance that helps reduce the cost of prescription drugs that you take yourself.  — Read Full Answer

 

Q: Are there different types of Part D prescription drug plans?

A: Yes. There is no single source of Medicare prescription drug coverage. You must get it either through a Part D “stand-alone” plan or through a Medicare Advantage health plan that offers both medical and drug benefits. — Read Full Answer

 

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

A: You need to choose a drug plan according to the specific prescription drugs that you take. — Read Full Answer

 

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

A: No, you can’t be enrolled in more than one Part D plan at the same time. But, if you want to, you can switch to a different plan at certain times. — Read Full Answer

 

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

A: Yes, you have many choices in how your receive health and drug benefits from Medicare. — Read Full Answer

 

Q: How do I know which drugs are covered by my Part D plan?

A: No Part D drug plan covers all prescription drugs. But each plan must make available the list of drugs it covers (known as a formulary). — Read Full Answer

 

Q: How can I find out which Part D drug plans cover the prescription drugs I take?

A: The best way of finding out which Part D plans cover the prescription drugs you take is to use the online Medicare plan finder program — either yourself or by getting somebody else to use it for you. — Read Full Answer

 

Q: What is a formulary?

A: A formulary is the list of prescription drugs that a Medicare Part D drug plan covers. — Read Full Answer

 

Q: My Medicare Part D drug plan won’t cover my drug, although it’s on the plan’s list of covered drugs. Why is this happening? 

A: There are several possible explanations for a Part D plan not immediately providing coverage for a drug that it normally covers. Usually it means that the plan has set a “restriction” on your drug. — Read Full Answer

 

Q: Can I use my Medicare Part D drug coverage anywhere in the United States?  

A: Whether you can fill prescriptions in other parts of the nation depends on whether the Part D plan you enroll in offers national coverage. — Read Full Answer

 

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

A: No, there is no limit to the number of prescriptions that you can fill under your Part D plan. But no plan covers all drugs, and plans may limit the quantity of drugs filled under a single prescription in some situations. Also, Medicare excludes some types of drugs from Part D coverage. — Read Full Answer

 

 

 

What Medicare Does and Does Not Cover Q & A Home

 

Q: Does Medicare cover home health services?

A: Medicare covers some health care services provided in your own home, at no charge to you, but only if you meet certain conditions. — 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 cover long-term care, nursing home care or care in skilled nursing facilities?  

A: Medicare does not cover long-term care. But it covers short-term stays in skilled nursing facilities in certain circumstances. — Read Full Answer

 

Q: Does Medicare cover hospice care?

A: Medicare covers 100 percent of the cost of hospice services for terminally ill people who meet certain conditions. — Read Full Answer

 

Q: Does Medicare pay for routine hearing care?

A: The original Medicare program does not cover routine hearing care, although some Medicare Advantage plans cover it as an extra benefit. In both cases, coverage is provided for hearing treatment that Medicare considers medically necessary. — Read Full Answer

 

Q: Does Medicare pay for routine vision care?

A: The original Medicare program does not pay for routine vision care, although some Medicare Advantage plans cover this cost as an extra benefit. In both cases, though, coverage is provided for eye treatment that Medicare considers medically necessary. — Read Full Answer

 

Q: Does Medicare cover routine dental care?

A: The original Medicare program does not cover routine dental care, although some Medicare Advantage plans cover it as an extra benefit. In both cases, coverage is provided for dental treatment that Medicare considers medically necessary. — Read Full Answer

 

Q: Does Medicare cover routine foot care?  

A: Medicare does not cover routine foot care but does cover medically necessary podiatric tests and services to diagnose or treat foot injuries or diseases. — Read Full Answer

 

Q: Does Medicare cover chiropractic services?

A: Medicare pays for some chiropractic services but not others. — Read Full Answer

 

Q: What medical eqipment and supplies does Medicare cover?

A: Medicare covers a wide range of medical equipment and supplies — all of which must be medically necessary — but not everything. — Read Full Answer

 

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

A: Medicare helps people who want to quit smoking tobacco in two ways — by providing coverage for counseling and prescribed medications. — Read Full Answer

 

Q: Does Medicare pay for the pneumonia shot?

A: Yes, Medicare covers the pneumonia vaccine under the Part B benefit. — Read Full Answer

 

Q: Will Medicare pay for my flu shot?

A: Yes, Medicare pays for one flu shot in each flu season, which runs from November through April. — Read Full Answer

 

Q: Does Medicare cover the vaccine for shingles?

A: Medicare covers the shingles vaccine but only through Part D prescription drug plans. — Read Full Answer

 

Q: Will Medicare pay for a yearly physical examination?

A: No, Medicare does not pay for routine physical exams. But it does cover an annual “wellness visit” that is intended to keep track of your health.  — Read Full Answer

 

Q: What is the “Welcome to Medicare” checkup?

A: The “Welcome to Medicare” checkup is an optional one-time opportunity for a doctor to assess your health when you first enter the Medicare program, free of charge. It serves as a baseline for monitoring your health in future years. — 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: What is the annual wellness visit?

A: Medicare’s annual wellness visit is a free preventive benefit that allows a doctor to monitor your health on a yearly basis. — Read Full Answer

 

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

A: Medicare covers colonoscopy screening free of charge if certain conditions are met, but you would pay a share of the cost for additional treatment. — Read Full Answer

 

Q: Which preventive services does Medicare cover free of charge?

A: Medicare makes no charge for a wide range of tests, screenings and services that help detect and prevent or stave off some of the diseases that make people very ill. — Read Full Answer