Will Medicare Cover All My Health Care Costs? (2024)

FAQs

Does Medicare pay for all medical expenses? ›

No. Even though Medicare can cover many of your health care costs, you'll still have some out-of-pocket expenses, including premiums, deductibles, copayments and coinsurance.

You'll usually pay 20% of the cost for each Medicare-covered service or item after you've paid your deductible. If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs, like deductibles, coinsurance, and copays. Learn more about help with costs.

Medicare is a federally funded insurance program for eligible participants 65 or over. Medicare has two parts, Part A (Hospital Insurance) and Part B (Medical Insurance). Medicare does not cover 100% of all costs.

After you pay the Part A deductible, Medicare pays the full cost of covered hospital services for the first 60 days of each benefit period when you're an inpatient, which means you're admitted to the hospital and not for observational care. Part A also pays a portion of the costs for longer hospital stays.

We don't cover these routine items and services: Routine or annual physical checkups (visit Medicare Wellness Visits to learn about exceptions). exams required by third parties, like insurance companies, businesses, or government agencies. Eye exams for prescribing, fitting, or changing eyeglasses.

Your annual deductible must be met before Medicare covers the full 80% of medically necessary doctors' visits. In 2024, the deductible for Part B is $240. Preventive services will be paid in full by Medicare, even if your deductible hasn't been met.

Most plans include Medicare drug coverage (Part D). There's no yearly limit on what you pay out of pocket, unless you have supplemental coverage—like Medicare Supplement Insurance (Medigap). Plans have a yearly limit on what you pay out of pocket for services Part A and Part B cover.

If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($174.70 in 2024). Social Security will tell you the exact amount you'll pay for Part B in 2024.

Medicare is a federally funded insurance program for eligible participants 65 or over. Medicare does not cover 100% of all costs and you may wish to purchase other Medicare-related insurance products such as Medicare Advantage or a Medicare Supplement policy.

Does Medicare pay 80% of everything? ›

Part B typically covers 80% of doctors' services, lab tests and x-rays, but you'll have to pay 20% of the costs after a $240 deductible in 2024. A Medigap (Medicare supplement) policy or Medicare Advantage plan can fill in the gaps if you don't have the supplemental coverage from a retiree health insurance policy.

In some cases, you'll have a higher share of costs when you see an out-of-network doctor. In other cases, you're not covered at all if you go out of network. This is particularly important if you travel a lot because Medicare Advantage plans generally don't provide out-of-state coverage.

In contrast, traditional Medicare does not have an out-of-pocket limit for covered services. In 2024, the out-of-pocket limit for Medicare Advantage plans may not exceed $8,850 for in-network services and $13,300 for in-network and out-of-network services combined.

Original Medicare covers things like inpatient hospital care, doctors' services and tests, and preventive services. You pay for services and items as you get them.

You pay nothing for covered services the first 20 days that you're in a skilled nursing facility (SNF). You pay a daily coinsurance for days 21-100, and you pay all costs beyond 100 days. Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to get current amounts. TTY users can call 1-877-486-2048.

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine physical exams. Cosmetic surgery.