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Medicare Coverage FAQs

What does Medicare Part A cover?

Part A is often called hospital insurance. It helps pay for inpatient care in a hospital, a critical access hospital, or a skilled nursing facility, and it also helps cover hospice care and some home health care.

What does Medicare Part B cover?

Part B is medical insurance. It helps pay for medically necessary services, like doctor visits, outpatient care, ambulance services, durable medical equipment, and some mental health care. It also covers many preventive services. If you’re not sure what Part B would mean for you, I can walk you through it.

Does Medicare cover prescription drugs?

Original Medicare covers only a limited set of outpatient drugs under Part B. For most prescriptions, you’d add Medicare drug coverage (Part D), which is optional and offered by private companies approved by Medicare. Even if you don’t take many medications today, joining when you’re first eligible can help you avoid a late enrollment penalty later. I can help you compare drug plans available in Temecula, Murrieta, and nearby.

Is preventive care like a flu shot or a yearly wellness visit covered?

Yes. Part B covers many preventive services, including flu, COVID-19, pneumococcal, and hepatitis B shots, many cancer and diabetes screenings, and a yearly “Wellness” visit to build a personal prevention plan. You usually pay nothing for most of these when your provider accepts assignment. Keep in mind the yearly Wellness visit isn’t the same as a routine physical, and other tests done at the same visit can have costs.

Does Medicare cover dental, vision, and hearing?

In most cases, Original Medicare doesn’t cover routine dental care (like cleanings, fillings, or dentures), routine eyeglasses or contacts, or hearing aids and fitting exams. There are limited exceptions, such as certain dental care tied to a covered medical treatment, or one pair of glasses after cataract surgery with a lens implant. Some Medicare Advantage plans offer extra dental, vision, or hearing benefits.

Does Medicare pay for long-term care or a nursing home stay?

Medicare doesn’t pay for long-term custodial care, which is help with everyday tasks like bathing, dressing, and using the bathroom, whether at home, in assisted living, or in a nursing home. That’s different from short-term skilled nursing care, which Part A can help cover after a qualifying hospital stay. Some people get long-term care help through Medicaid if they qualify, or plan ahead with private long-term care insurance.

Does Medicare cover me when I travel outside the U.S.?

Usually not. Original Medicare only covers care outside the U.S. in a few rare situations, mostly involving inpatient hospital care. Many Medicare Supplement (Medigap) policies include foreign travel emergency coverage, and some Medicare Advantage plans offer it as an extra benefit, so it’s worth checking before a trip.

Do Medicare Advantage plans cover more than Original Medicare?

Medicare Advantage (Part C) plans must cover at least what Original Medicare covers, and many also include extras like dental, vision, or hearing benefits, and often drug coverage. Plan rules, provider networks, and costs vary from plan to plan and area to area. I can help you look at which Medicare Advantage plans are available in Temecula, Murrieta, Menifee, and nearby.

How much does Part B cost in 2026?

For 2026, the standard Part B premium is $202.90 a month, and the yearly Part B deductible is $283. After you meet the deductible, you typically pay 20% of the Medicare-approved amount for most covered services. Some people pay a higher premium based on income.

How can I find out whether a specific test, item, or service is covered?

Start by asking your doctor or provider whether Medicare covers the test, item, or service and what your share of the cost will be. Your costs can depend on other insurance you have, whether your doctor accepts assignment, and where you get the care. You can also look up coverage on Medicare.gov, or call me and I’ll help you check.

Source: Medicare.gov. Coverage details can change; check your plan documents or ask me for help.

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