What does Medicare cover?

What does Medicare cover?

It surprises many people to learn that Social Security employees are not good sources of information about what Medicare covers.

Other than providing general information, the primary Social Security role concerning Medicare is to help people enroll in the program. The Centers for Medicare & Medicaid Services (CMS), a component of the Department of Health & Human Services  is the agency in charge of the Medicare program.

General information about Medicare is at available through the Social Security Administration website, www.socialsecurity.gov. The booklet, Medicare, (SSA publication 05-10043) provides an overview of the program and is a good place to start when learning about Medicare. Read it at http://www.socialsecurity.gov/pubs/10043.html  or get a copy from any Social Security office.

Here is some information from that booklet:

Medicare has four parts

  • Hospital insurance (Part A) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care.
  • Medical insurance (Part B) helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance.
  • Medicare Advantage (Part C) plans are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through one of these provider organizations under Part C.
  • Prescription drug coverage (Part D) helps pay for medications doctors prescribe for treatment.

Detailed Medicare coverage information is in the annual publication Medicare and You. This official government booklet has a summary of Medicare benefits, coverage decisions, rights and protections, and answers to the most frequently asked questions about Medicare. The current version, Medicare and You 2013, is online at http://www.medicare.gov/Pubs/pdf/10050.pdf.

You can order a paper copy of Medicare and You 2013 from the publication section of the Medicare website, www.medicare.gov/publications. A paper copy can also be requested by calling the Medicare toll-free number, 1-800-Medicare (1-800-633-4227) (TTY 1-877-486-2048). 

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