Get Started With Medicare

A plain-English guide to what Medicare covers, what Original Medicare usually does not cover, and how to check specific services before you make a coverage decision.

The short answer

Original Medicare includes Part A and Part B. Part A is generally associated with inpatient hospital care, skilled nursing facility care after a qualifying hospital stay, hospice care, and some home health care. Part B is generally associated with doctor services, outpatient care, preventive services, durable medical equipment, and medically necessary services.

That short answer is useful, but it is not enough for a real-life decision. Coverage can depend on the service, medical necessity, provider participation, where care is received, whether a deductible or coinsurance applies, and whether you use Original Medicare or a private Medicare Advantage plan.

What Part A usually covers

Part A is often called hospital insurance. It can help pay for inpatient hospital care, limited skilled nursing facility care, hospice care, and some home health care when Medicare rules are met.

Part A coverage still has limits and costs. A hospital stay, skilled nursing facility stay, or home health situation can involve specific eligibility rules, benefit periods, deductibles, coinsurance, and documentation requirements.

What Part B usually covers

Part B is often called medical insurance. It can help cover doctor visits, outpatient care, preventive services, medically necessary services, durable medical equipment, lab tests, imaging, ambulance services when rules are met, and certain drugs given in a medical setting.

Part B does not mean every outpatient bill is paid in full. You may still owe the Part B premium, deductible, coinsurance, and any costs for services Medicare does not cover.

What Original Medicare usually does not cover

Original Medicare generally does not cover most routine dental care, routine eye exams for glasses, most eyeglasses or contact lenses, hearing aids and exams for fitting them, most long-term custodial care, and most prescription drugs you take at home unless you have separate drug coverage.

This is one reason people often review Part D, Medigap, Medicare Advantage, employer retiree coverage, Medicaid, VA-related benefits, or other coverage. The right question is not only whether Medicare covers a service, but which part or coverage path would handle it.

How to check a specific service

Use Medicare.gov's coverage search when you want to check a specific test, item, or service. Search by the service name, then read the conditions and cost-sharing notes carefully.

If you are in a Medicare Advantage plan, also check the plan's Evidence of Coverage, provider network, prior authorization rules, referrals, drug formulary, and cost-sharing. Medicare Advantage plans must cover Medicare-covered services, but they can use plan rules and networks.

Coverage questions that affect costs

A service can be covered and still cost money. Before scheduling care, ask whether the provider accepts Medicare, whether the service is medically necessary, whether prior authorization or referral rules apply, whether the service falls under Part A, Part B, Part D, or a private plan, and what your likely out-of-pocket cost may be.

For recurring care, prescriptions, dental needs, hearing needs, or a planned procedure, write down the service and ask the question in plain language: who pays, what rules apply, and what could I owe?

Questions to ask

Is this service covered under Part A, Part B, Part D, or a private plan?
Does Medicare require medical necessity, documentation, a referral, or prior authorization?
What deductible, copay, or coinsurance may apply?
Does my provider accept Medicare or participate in my plan's network?
Is this service excluded from Original Medicare unless I have other coverage?

Quick review checklist

Assuming Medicare covers every service that a doctor recommends.
Forgetting that Original Medicare usually does not cover most routine dental, vision, hearing, or long-term custodial care.
Checking only whether a service is covered and not checking deductibles, coinsurance, networks, or prior authorization rules.
Assuming Medicare Advantage and Original Medicare handle every service the same way.

When to get licensed help

Licensed help may be useful when you need to compare coverage choices, confirm enrollment timing, or understand how your current coverage coordinates with Medicare. This website does not sell, enroll in, or recommend specific Medicare plans.

Frequently asked questions

Does Medicare cover dental, vision, and hearing?

Original Medicare generally has limited coverage for routine dental, vision, and hearing services. Some Medicare Advantage plans may include extra benefits, but rules, networks, and costs vary by plan.

Does Medicare cover long-term care?

Original Medicare generally does not cover most long-term custodial care. It may cover certain skilled care when Medicare rules are met, but custodial help with daily activities is different.

Where can I check if Medicare covers something?

Use Medicare.gov's official coverage search for specific tests, items, and services. If you have a Medicare Advantage plan, also check your plan documents and contact the plan.

What Does Medicare Cover?