Medicare Benefits Every Senior Should Know About |

If you’re nearing 65 years of age or are younger with a disability or End-Stage Renal disease, you’ve probably heard of Medicare and maybe even started learning about enrollment.

The next step is to learn what benefits Medicare covers, which may be confusing to some because there are so many different parts to consider.

Multiple generations of a family at a picnic

The four parts of Medicare

There are two parts to ”Original Medicare” — Part A and Part B — and each part covers a different set of benefits.

  • Generally speaking, Medicare Part A (Hospital Insurance) covers inpatient hospital care, skilled nursing facility care, hospice care, and limited home health care.

  • Medicare Part B (Medical Insurance) covers doctor’s services, surgery, lab tests, durable medical equipment and certain preventive services.

There are other options (such as Part C, Part D and Medicare Supplement Insurance) that offer benefits that Original Medicare does not.

So before you enroll in Medicare, it might help you to know exactly what Original Medicare helps pay for so you can make an informed decision about your Medicare coverage.

What does Original Medicare cover?

The table below is offered as a reference, but may not be comprehensive.

Service or Supply Part A Part B

Abdominal aortic aneurysm screening




Alcohol misuse screening and counseling


Ambulance services


Ambulatory surgical centers



✔ - inpatient

✔ - outpatient

Artificial limbs and eyes



✔ - inpatient

✔ - outpatient

Blood processing and handling

✔ - inpatient

✔ - outpatient

Bone mass measurement


Braces (arm, leg, back and neck)


Breast prostheses/reconstruction

✔ - inpatient

✔ - outpatient



Cardiac rehabilitation program


Cardiovascular disease behavioral therapy


Cardiovascular disease screenings


Cervical and vaingal cancer screenings



✔ - hospital patients

✔ - hospital outpatients and freestanding clinic and doctor’s office patients

Chiropractic services


Clinical research studies

Colorectal cancer screening


Commode chairs


Continuous passive motion (CPM) machine


Continuous Positive Airway Pressure (CPAP) therapy


✔ - 3-month trial and possibly longer

Concierge care


Cosmetic surgery

NO - unless needed because of accidental injury or malformation

NO - unless needed because of accidental injury or malformation

Custodial care



Dental Services


Depression Screening


Diabetes screenings


Diabetes services and supplies


Diagnostic tests


Dialysis (kidney) services and supplies

✔ - inpatient

✔ - outpatient, training and equipment

Doctor and other health care provider services


Durable medical equipment (DME)


EKG (electrocardiogram) screening


Emergency department services


Eye exams


Eyeglasses/contact lenses


✔ - for corrective lenses after cataract surgery only

Federally qualified health center services


Flu shots


Foot care


Glaucoma tests


Health education/wellness programs


Hearing and balance/hearing aids


✔ - doctor ordered

Hepatitis B shots


✔ - if at high or medium risk

Hepatitis C screening test


HIV screening


Home health services

Hospice care


Hospital bed (see “Durable medical equipment”)




Hyperbaric oxygen (HBO) therapy


Inpatient hospital care

✔ - doctor’s services while you are in hospital

Kidney disease education


Laboratory tests (clinical)


Lung cancer screening


Macular degeneration




Mental health care

✔ - inpatient

✔ - outpatient

Nursing home care

✔ - for medically necessary skilled care


Nutrition therapy services


✔ - for services related to diabetes or kidney disease

Obesity screening & counseling


✔ - for people with BMIs of 30 or over

Orthotics, artificial limbs, and eyes


Ostomy supplies


Outpatient hospital services


Oxygen equipment and accessories


Physical therapy/occupational therapy/speech-language pathology services


Pneumococcal shots


Prescription drugs (outpatient) limited coverage


✔ - limited coverage

Preventive services


Preventive visits


Prostate cancer screenings


Prosthetic devices


Pulmonary rehabilitation program


Radiation therapy

✔ - inpatient

✔ - outpatient

Religious nonmedical health care institution (RNHCI) items


Rural health clinic services


Second surgical opinions


Sexually transmitted infections screening and counseling




✔ - flu, hepatitis B and pneumococcal

Skilled nursing facility (SNF) care


Smoking and tobacco-use cessation counseling


Supplies (you use at home)


Surgical dressing services




Transplants (doctor services)


Transplants (facility charges)


Transportation (routine)


Travel (healthcare needed outside of U.S.)


Urgently needed care






Medicare Part C and Part D

As mentioned before, there are other benefits that aren’t part of Original Medicare.

  • Medicare Part C (Medicare Advantage plans) allows private insurance companies to sell health insurance plans that offer at least the same benefits as Original Medicare.

    In many cases, Medicare Advantage plans offer additional coverage as well — like prescription drugs, vision and dental. But like traditional health insurance plans, their cost, coverage areas and benefits vary.

  • Medicare Part D (prescription drug coverage) adds prescription drug coverage to Medicare.

    You can either buy a freestanding Prescription Drug Plan to use in conjunction with Original Medicare or a Medicare Advantage plan that doesn’t include drug coverage, or you can buy a Medicare Advantage plan that includes drug coverage (MA-PD plans).

    You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes by visiting

Like Part C, Prescription Drug Plans are offered through private insurance companies.

To learn more about your Medicare options, call today to speak with a licensed insurance agent.


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