Part A, Part B, Part C, Part D, Medicare Advantage - Wow, what a mouthful! Do the different Medicare elements confuse you?

If you're in a Medicare Advantage plan or other Medicare plan, your plan may have different rules. But, your plan must give you at least the same coverage as original Medicare.

-Foundation for Financial Wellness

Video Transcript

Medicare coverage is basically based on three main factors. One, federal and state laws. Two, national coverage decisions made by Medicare about whether something is covered or not, and three, local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

But in general, Part A covers inpatient care like in a hospital, skilled nursing facility care, nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care). It also covers hospice care, home health care, and there are two ways to find out if Medicare covers whatever it is that you may be in need of.

Talk to your doctor or other health care provider about why you need certain services or supplies, and then ask if Medicare will cover them. You may need something that's usually covered, but your provider thinks that Medicare won't cover it in your situation. If so, you'll have to read and sign a notice that says that you may have to pay for the item, the service, or the supply. The bottom line - To find out if Medicare covers your item, or service, or supply, go to www.medicare.gov/coverage.

Lastly, a noteworthy point to make here - If you're in a Medicare Advantage plan or other Medicare plan, your plan may have different rules. But, your plan must give you at least the same coverage as original Medicare. Some services may only be covered in certain facilities or for patients with certain conditions.

OK, a quick review here for you to decide if you have any decisions to make or actions to take.

One, begin compiling questions that you want to ask your Medicare professional. Two, keep that website address in your notes. Remember it was www.medicare.gov/coverage. That way you can always go back and see if Medicare covers any specific item that you may need.

As always, don’t forget to take advantage of your private counseling session. It’s included, it’s private and confidential, and it’s always with one of our Certified Financial Wellness Counselors. To schedule that session, simply click on the “Request Counseling” button.