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How Medicare & Medicare Advantage Work with Different Types of Care

The terms that come with Medicare and Medicare Advantage (MA) plans can be difficult to understand because there is just so much information to digest! Because of this, policyholders can have a difficult time knowing what services are available to help them with care needs.

To help policyholders understand what they have access to and how Medicare and MA work with different types of care, we put this detailed guide together below. Make sure to save this and reference it when you need it!

Types of Care and How Medicare & MA Work

Health Care

Depending on qualifications and current health needs, Medicare Parts A and B can cover: 

  • Short-term or part-time home health services
  • Short-term or part-time skilled nursing care
  • Physical Therapy
  • Occupational therapy
  • Speech services
  • Medical social services

It’s also important to note some of the things Medicare doesn’t cover:

  • Long-term care
  • Eye exams for prescription glasses
  • Cosmetic surgery
  • Massage therapy
  • Routine physical exams
  • Concierge care
  • Hearing aids

For any of the items above, you may be able to get assistance with supplemental plans (Part C, D, Medigap, etc.) or find third-party resources that can help. We’re linking some of these resources below so make sure to check them out!

Personal Care

Most Medicare Part C plans cover in-home care needs like bathing and grooming assistance, mobility assistance, medicare management, and more. They also provide policyholders with recovery or post surgical services to reduce the time spent in a hospital.

Again, you will want to do research beforehand because Plan C terms vary from region to region.

Household Care

The original Parts A and B don’t cover household-related needs like in-home cleaning services. If you need this type of assistance, you will need to invest in an MA plan.

MA plans are now more flexible, meaning more services are being offered. Depending on if you have a condition, your region, etc., you may have access to services like home air cleaners, carpet cleaning, and more.

Behavioral Wellness Care

Behavioral Wellness care needs are primarily covered by Medicare Plans A and B. With Part A, you can have things like standard nursing care, inpatient therapy, and testing and some medications covered. With Part B, you can get ongoing help with things like clinical social worker appointments, specialized counseling appointments, some medications, and more.

You can also get additional help with supplemental plans C, D, and Medigap.

  • Plan C covers everything from Parts A and B, and you can get more coverage depending on area
  • Part D can help you cover costs of different medications like stabilizers, antidepressants, and more
  • Medigap can help cover fees associated with inpatient or outpatient care

Additional Resources

How do I sign up for Medicare?

How to Join a Medicare Advantage Plan

Hearing Aid Resources for Older Adults

Eye Care Guide for Older Adults

Healthy Hive

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