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What does Medicare cover?

Medicare eligible male patient with a male doctor discussing Medicare coverage

Depending on the plan you select, Medicare coverage can include:

  • Outpatient and inpatient medical services (Original Medicare)
  • Comprehensive care (Medicare Part C) that includes all of what Original Medicare covers plus benefits like dental, vision, hearing, and more
  • Prescription drug coverage (Medicare Part D)

What does Original Medicare cover?

Original Medicare has two parts: Medicare Part A coverage and Medicare Part B coverage.

  • Medicare Part A coverage includes hospital stays, skilled nursing, and in-home medical care. Think of it as your inpatient care coverage for unexpected injury or illness.
  • Medicare Part B coverage provides for your everyday medical needs including doctor visits, medical tests, X-rays, medical supplies, and long-term preventive care. Think of it as everyday medical coverage that keeps you healthy.

What is not covered by Medicare?

Many people need more coverage than Original Medicare provides. For example, Part A and Part B of Medicare do not cover prescription drugs, dental, vision, or hearing.

What is Part C or Medicare Advantage plan coverage?

Medicare Advantage plans give you added coverage and act as comprehensive all-in-one plans. They include Medicare Part A and Part B plus additional benefits like:

  • Dental care including cleanings, X-rays, and dentures
  • Vision care including contacts and glasses
  • Hearing care including hearing aids and regular testing
  • Other benefits including online fitness classes and an allowance for over-the-counter healthcare items

What is Part D prescription drug coverage?

Part D Medicare insurance covers prescription medications. If prescription drugs are part of your ongoing healthcare, then you may want to add a Part D plan to your Original Medicare coverage. Or you can choose a Medicare Advantage plan that includes prescription drug coverage.

Not sure about Medicare coverage for certain healthcare needs?

Talk to your doctor. If it’s not clear whether your treatment, medication, or any other procedure is covered, just ask. Compare Medicare coverage with Empire to find a plan that fits your changing health needs.

When are you eligible for Medicare coverage?

You’re eligible for Medicare when you turn 65. Around the time of your 65th birthday, there’s a seven-month window called the Initial Enrollment Period (IEP), when you can apply for Medicare:

  • Three months before you turn 65
  • The month you turn 65
  • Three months after you turn 65

If you miss your IEP, you have another chance to enroll. You can sign up for Medicare Part A and Part B between January 1 and March 31 each year. Your Medicare coverage then begins on July 1 of the same year.

Can you change your Medicare coverage once you’ve enrolled?

If you find you need more coverage or want a different plan after you’ve enrolled in Medicare, you can apply for a new plan during the Annual Enrollment Period — also known as the Annual Election Period. This window, from October 15 to December 7 each year, allows you to add, drop, or change your coverage. You also have a chance to change your existing Medicare Advantage plan from January 1 to March 31 during the Medicare Advantage Open Enrollment Period. The most important thing is to find the Medicare coverage that works for you.

Find a Medicare plan that fits your coverage needs. Explore your plan options.

Shop Medicare Plans Today


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