Missouri Medicare Advisors Logo

Phone Number

(417) 633-7200

Location

Springfield, Missouri

Medicare Coverage

It is important to understand the coverage that Original Medicare offers. By understanding this, Medicare beneficiaries can make more informed decisions about other types of insurance that they choose to enroll in.

Original Medicare Coverage

Original Medicare consists of Parts A and B. Together, these offer coverage for inpatient and outpatient services such as hospital stays, doctor visits, medical equipment, lab tests, preventive services, and more.

Medicare Part A Benefits

Part A benefits include:

  • A semi-private room
  • Operating room
  • Post-op recovery room
  • Care in special units
  • Hospital meals
  • Lab tests
  • X-rays
  • Medications and equipment
  • Rehabilitation services while and inpatient
  • Blood transfusions
  • Hospice
  • Skilled nursing care

Medicare Part B Benefits

Part B offers coverage for many outpatient medical services. It offers benefits for preventive services like cancer screenings, vaccines, lab work, and many more preventive services. It will also help pay for mental health services and durable medical equipment.

While Part A is your “room and board” for hospital stays, Part B will also pay for services performed while under inpatient hospital care. It will cover diagnostic images, surgeries, dialysis, chemotherapy, and medications delivered by injection.

Medicare Part D Benefits

Part D includes prescription drug coverage. The specific prescriptions covered will depend on the plan.

What is not included in Medicare coverage?

Original Medicare does not offer long-term care, acupuncture, or routine dental, vision, and hearing services. It does not pay for hearing aids or any cosmetic procedures.

Medicare Age Requirements

Individuals who have been receiving disability benefits for 24 months or who have been diagnosed with ALS or ESRD can qualify for Medicare at any age. Otherwise, individuals must be at least 65 years old to enroll in medicare.

Effective Dates for

Medicare

Medicare coverage will begin at age 65 or on the 25 month of disability benefits. However, not all individuals are automatically enrolled in Medicare, so effective dates will be based on when the individual submits their application.

The Initial Enrollment Period is the best time to apply for those who are turning 65. It begins three months prior to their 65th birthday and ends three months after.

Individuals may qualify for a Special Enrollment Period in some cases and there is also a General Enrollment Period for those who miss their initial enrollment and do not qualify for a special enrollment. The General Enrollment Period runs from January 1 through March 31. Enrolling during this time makes the effective date July 1.

Losing Medicare Coverage

Individuals can not be removed from the Medicare program unless they fail to make the premium payments or no longer have the disability that made them eligible.

Applying for Medicare

Individuals can apply for Original Medicare in one of three ways. They can apply online at SSA.gov, apply over the phone with the Social Security office, or make an in-person appointment at their local Social Security office.

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