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Medicare can be confusing!  Here are some basics about your Medicare Benefits:

In general, Part A covers:

• Hospital care
• Skilled nursing facility care
• Nursing home care (as long as custodial care isn’t the only care you need)
• Hospice
• Home health services

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.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

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

What Drug Plans Cover:

Each Medicare drug plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different “tiers” on their formularies. Drugs in each tier have a different cost.

A drug in a lower tier will generally cost you less than a drug in a higher tier. Your prescriber may think you need a drug that’s on a higher tier. If so, you or your prescriber can sometimes ask your plan for an exception to get a lower copayment.

A Medicare drug plan can make some changes to its formulary during the year within guidelines set by Medicare. If the change involves a drug you’re currently taking, your plan must do one of these:

• Provide written notice to you at least 60 days prior to the date the change becomes effective.
• At the time you request a refill, provide both of these:
  • A written notice of the change
  • A 60-day supply of the drug under the same plan rules as before the change

What Parts A & B don’t cover:

Medicare doesn’t cover everything. If you need certain services Medicare doesn’t cover, you’ll have to pay for them yourself unless:

• You have other insurance that covers them
• You have a Medicare health plan that covers them

Even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments.

Some of the items and services that Medicare doesn’t cover include:

• Long-term care (also called custodial care)
• Most dental care
• Eye exams related to prescribing glasses
• Dentures
• Cosmetic surgery
• Acupuncture
• Hearing aids and exams for fitting them
• Routine foot care

Disclaimer: All information in this section sourced from Medicare.gov