07/01/2019

Understanding the different Parts of Medicare Coverage


We all know how difficult and frustrating it can be to navigate the world of Medicare. CMS is continually evolving, and we need to keep ourselves update or risk falling into an abyss we can not climb out of.



Luckily Episode Alert is here for you. We are going to take a look at each of Parts of Medicare A through D and see what we can teach you. Our goal is to give you a strong foundation of understanding, so you do not fall into the abyss like so many others before you. So let’s get started.


What is Part A?


Medicare Part A coverage takes effect when you admitted to the Hospital or when a doctor officially makes the judgment you need to become an inpatient to the Hospital. Of course, the Hospital must cover Medicare or the Utilization Review committee* of the Hospital approves your stay (this only takes place in some instances)


Utilization Review Committee Basically, what these committees need to do is take a look at your medical records and make a judgment on whether your admittance is medically necessary. There is a lot more to this, and if you are interested we recommend you check out Utilization review here:Utilization Review Committee




What will Part A cover?

episode alerts part a coverage medicare infograph

If your wondering what type of facilities are included under Part A here are some:


  • Mental Health Care (psychiatric hospital stays are limited to 190 days in a lifetime)

  • Inpatient rehab facility

  • Qualified clinical research inpatient care

  • Long-term care hospitals

  • Critical access hospital

  • Acute care hospital


Side note- You will have to pay out of pocket for a phone or television in your room, private nurse or if you want a private room (unless medically necessary)


What is Part B?


There are two types of services Part B covers:


The first is Medically necessary services which are services or supplies to treat your condition or to diagnose that meet specific standards.


The second is Preventive services used by healthcare providers to prevent illness like the flu or to identify that illness very early.


What does Part B cover?


episode alerts part b coverage medicare infograph

What is Part C?

Part C goes by another name, which is Medicare Advantage. Private insurance companies contracted to Medicare runs part C. Medicare advantage covers the same thing Part A does; it also includes Home Health Care.


Some extra benefits to Medicare Part C are:

  • Dental Care

  • Vision Care

  • Hearing Care

  • Fitness benefits


episode alerts part c coverage medicare infograph

What is Medicare Part D?


Simply put part D is the Medicare prescription drug plan. It is provided through insurance companies contracted through Medicare. You can check to see what type of prescription drugs are covered here:Part D coverage


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