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Medicare may cover many medical expenses, but it doesn’t cover everything. Budgeting for expected medical expenses may help you avoid financial problems from costly medical care.
There are different types of Medicare coverage that may help you manage medical expenses. Here’s an overview of the types of medical expenses that different parts of Medicare may cover. We’ll also discuss other types of Medicare coverage.
Medicare Part A provides coverage for inpatient hospital care. It may also cover inpatient rehabilitation services, skilled nursing facility care, hospice care, and limited home health services. Your medical expenses for Medicare Part A covered services might include:
Medicare Part B generally covers a wide range of medical expenses. There are rules and restrictions for each, Here’s just a sample of covered services:
Generally, you pay 20% of the Medicare-approved amount for most Part B covered services after you have paid an annual deductible. (The standard deductible is $185 for 2019.)
If you enroll in a prescription drug plan under Medicare Part D, your expenses will depend on your medications and the plan you choose. Medicare prescription drug coverage is optional, but it can come in handy when you’re taking medications to treat health conditions. Private insurance companies contracted with Medicare provide these plans. Your Medicare Part D expenses might include:
Here are a couple of coverage options that may be good to know about. Perhaps one of them could help with your medical expenses under Medicare.
Medicare Supplement (Medigap) insurance plans are designed to work alongside Medicare Part A and Part B. They may help pay some of your medical expenses for covered services that Medicare doesn’t pay. These out-of-pocket costs may include deductibles, coinsurance, copayments, and other costs.
For example, if you spend a lot of time as a hospital inpatient, you might want to know that Medicare Supplement insurance plans typically cover your inpatient costs under Part A for an additional 365 days after your Medicare benefits expire.
Offered by private insurers, Medicare Supplement insurance plans provide standardized plans with lettered names in most states, which makes these Medicare Supplement insurance plans easy to compare.
Medicare Advantage (Medicare Part C) provides an alternative way to receive your Medicare Part A and Part B benefits. They’re offered by private insurance companies contracted with Medicare. Medicare Advantage plans may offer additional benefits that might reduce your medical expenses.
Many Medicare Advantage plans provide coverage for routine dental care, routine vision care and eyewear, hearing aids, and/or other benefits. Often Medicare Advantage plans include prescription drug coverage. Medicare Advantage plans may offer other supplemental benefits that Medicare does not cover, such as standard gym memberships, transportation to doctor’s offices, over-the-counter drugs and supplies, safety devices for the home, and acupuncture or other alternative therapies.
Each Medicare Advantage plan must limit the annual out-of-pocket medical expenses you pay for covered services. In 2019, the maximum out-of-pocket medical expense you could pay is $6,700; thereafter, the plan may pay 100% for covered medical services for the rest of the year. Many plans set lower out-of-pocket limits.
It’s common for Medicare Advantage plans to have networks of participating providers you must use to minimize your medical expenses for covered services. Deductibles, copayments, and coinsurance vary among Medicare Advantage plans as do any extra benefits they may offer.
Most types of health-care coverage come with monthly premiums, and this is often true with Medicare.
When comparing premium costs, you might want to resist the temptation to select the least expensive plan right away. It may help you to choose a plan with a higher premium if it provides better coverage for medical expenses you’re likely to have.
Medicare premiums and cost-sharing requirements can change from year to year. It’s a good idea to review your Medicare coverage each year so you to decide if your current plan meets your health needs and if the projected medical expenses are still within your budget.
If you stay with Medicare Part A and Part B, make sure he or your doctor accepts Medicare assignment. That’s the Medicare-approved amount for covered services.
If you have a Medicare Advantage plan or a stand-alone Medicare Part D prescription drug plan, here’s a way you might keep your medical expenses as low as possible. Use the plan’s in-network providers and pharmacies. Sometimes you can save money on prescriptions if the plan has a mail-order discount.
You may be eligible for financial help for:
Are you interested in finding out more about Medicare plans that might help you manage your medical expenses? You can enter your zip code and click the button on this page to start comparing Medicare Supplement insurance plans, stand-alone Medicare Part D prescription drug plans, and Medicare Advantage plans.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.