Medicare Part A And Part B Coverage

Understanding What Part A and Part B Covers

Part A and Part B form the foundation of Medicare. They provide coverage if you are enrolled in Original Medicare, which has been in place since 1966, although many additional services have been added over time. Part A and Part B also serve as the basis for Medicare Advantage plans, which are required by law to cover the same services as Original Medicare, though they may offer additional benefits.

If you want a complete walkthrough of Medicare parts, enrollment windows, and coverage options, see our Medicare Guide.

Important Clinical Consideration

Medicare covers services that are considered reasonable and necessary to save lives and maintain or improve health. This includes major procedures such as heart transplants, treatment for severe injuries, cancer therapies, and many other high-cost services. The program also covers more routine services, from allergy shots to X-rays.

Preventive Consideration

Preventive care has become an important part of Medicare coverage. In recent years, Medicare expanded coverage for services that help prevent or detect illnesses early. Many preventive tests, screenings, and counseling visits are now available at no cost (no copays or deductibles) if you see a provider who accepts Medicare assignment.

Specialized Care in Specific Conditions

Part A is generally associated with hospital care, but it also covers certain specialized services outside of the hospital, particularly those involving skilled nursing care. Part B covers various outpatient services, including physical therapy and other medically necessary treatments.

Care in a Skilled Nursing Facility

After a hospital stay, you may require additional skilled nursing care before returning home. This can include physical therapy after joint replacement, speech therapy after a stroke, or other medically necessary services. Under specific conditions, Medicare Part A covers care in a skilled nursing facility.

Home Health Care Services

Home health care allows you to receive certain medical services in your own home. Covered services may include:

• Skilled nursing care
• Physical, speech, and occupational therapy
• Home health aide services
• Medical supplies
• Medical social services

To qualify, you must be homebound, require skilled services ordered by a physician, and receive care from a Medicare-approved home health agency.

Hospice Care

Hospice care is designed for individuals facing a terminal illness when treatment intended to cure the condition is no longer effective or desired. The focus shifts from curing the illness to providing comfort, dignity, and support during the final stages of life.

Palliative Care

Palliative care focuses on relieving pain and other symptoms related to serious illness. Unlike hospice care, it does not require a terminal diagnosis and can be provided alongside curative treatments.

End of Life Care Guidance

Many individuals choose to plan in advance for end-of-life care to ensure their wishes are honored. Advance directives and care planning can provide peace of mind for both patients and their families.

Pregnancy and Labor

While Medicare is commonly associated with older adults, it also covers younger individuals who qualify due to disability. In certain situations, Medicare may cover pregnancy and labor for eligible beneficiaries.

Medical Supplies and Equipment

Medicare covers durable medical equipment such as wheelchairs, prosthetics, oxygen equipment, and other long-lasting medical items when medically necessary. Disposable or short-term use items are generally not covered.

This Medicare resource was provided by Amerus Insurance Group, a nationwide independent agency that helps seniors confidently compare plan options, control out-of-pocket costs, and enroll with the right coverage for their doctors, prescriptions, and lifestyle. Whether you’re new to Medicare or reviewing your current plan, speak with an Amerus advisor for a free, personalized consultation.