Medicare Services

People enrolled in Original Medicare have access to a range of inpatient and outpatient services.

• Medicare Part A: Medicare Part A covers inpatient care in a hospital, home health care, skilled nursing facility care and hospice services.
• Medicare Part B: Medicare Part B covers two main types of services: Medically necessary services or supplies and preventive services such as flu shots and cancer screenings. Clinical research, mental health services, durable medical equipment and ambulance transportation are all covered by Medicare Part B.

All Medicare Advantage plans are required to offer the same services as Original Medicare, but also provide  additional services such as dental and vision care.

Most Medicare beneficiaries are 65 and older. It’s important for this age group to stay on top of their health care, including taking measures to prevent illness or detect diseases at an early stage when treatment is more effective.

Medicare Part B offers preventive services to help you stay healthy in retirement. Many of these tests or screenings are fully covered by Medicare while others require cost-sharing for the beneficiary such as a copayment, coinsurance and a deductible.

Once you enroll in Medicare Part B, you have 12 months to receive a free “Welcome to Medicare” physical exam, according to AARP.

After you’ve been enrolled in Medicare Part B for a year, you are eligible for an annual wellness visit to build or update your prevention plan based on your current health and risk factors.

Vaccines are included under Medicare’s preventive services. Beneficiaries are covered for several preventive vaccines, including an annual flu shot. Medicare typically pays for the entire cost of the vaccine if it’s under coverage.

While Medicare does not cover all vaccines, some can be received if they are related to the treatment of a condition. Other vaccines are available through Part D prescription drug plans.

Medicare does cover durable medical equipment (DME). DME is typically a non-disposable item or type of equipment that assists with a medical condition. Examples include wheelchairs, canes or walkers, all of which Medicare can cover.

Medicare typically will not cover any disposable, temporary items or equipment that’s more substantial, like a hospital bed.

As with other items covered by Medicare, DME must be considered medically necessary for you to use for it to be covered.

There are certain services that Original Medicare does not cover, including long-term care and medical care overseas.

Enrolling in a Medicare Advantage plan may provide coverage of routine vision, dental or hearing care. Beneficiaries in need of prescription drug coverage can enroll in a Medicare Part D plan.

Medicare generally does not include any coverage for dental services. This means basic items and services like dentures or regular cleanings and checkups are not covered.

There are some dental services that can be covered in unusual circumstances, like if a tooth extraction is needed to prepare for radiation treatment. Dental coverage is often available through a Medicare Advantage plan.

Hearing is typically excluded from Medicare coverage. This means that hearing aids and exams to fit them will not be covered. Similar to dental, hearing coverage is often included in Medicare Advantage plans.

Medicare does not include vision coverage. Beneficiaries will have to pay out-of-pocket for any routine eye examinations. Glasses or contacts are also not covered. However, Medicare can cover some eye treatments related to medical conditions, such as macular degeneration.

Vision coverage is typically available through a Medicare Advantage plan.

Medicare Part B covers ambulance services in emergencies and some nonemergency scenarios.

Transportation by ambulance is covered to the nearest hospital, critical access hospital or skilled nursing facility appropriate for your emergency. Medicare may deny covering your ambulance service if it is determined that you could have safely traveled by other means of transportation, such as by car or taxi.

Medicare only covers ambulance service to the closest facility appropriate for your condition.

Limited nonemergency ambulance services and air ambulance services may be covered if you have a written order from your doctor saying it is medically necessary.

Medicare beneficiaries are responsible for 20% of the Medicare-approved cost of all ambulance services after meeting their Part B deductible.

Medicare Part A covers skilled nursing care that’s not custodial or long-term care. Hospice services are also covered, usually at no cost to you.

Original Medicare also covers select home health care services for eligible beneficiaries.

It is important to understand the difference between home health care and custodial care. Medicare does not cover 24-hour care. It also won’t cover homemaker services or personal care services if that’s all you require.

Writer Anna Baluch contributed to this article.