Original Medicare in Illinois consists of Part A (hospital insurance) and Part B (medical insurance). It’s the foundation of most people’s health coverage after 65 — often called Traditional Medicare — but it doesn’t pay for everything. Knowing what Medicare Part A covers, what Original Medicare covers, and what Traditional Medicare is helps you plan ahead and decide if you need additional protection, like a Medigap policy or a Medicare Advantage (MA) plan.
What Medicare DOES Cover
• Part A: Covers inpatient hospital stays, skilled nursing care after a qualifying hospital stay, hospice, and some home health care. Most people don’t pay a premium if they’ve paid Medicare taxes for 10+ years. This is the core of the question, “what does Medicare Part A cover?”
• Part B: Includes doctor visits, preventive services (like flu shots and mammograms), lab work, X-rays, durable medical equipment, mental health, and some home health. You’ll pay a monthly premium for Part B.
• Medicare Advantage: These plans must cover everything in Parts A and B, often adding extras like vision, hearing, dental, and drug coverage. Networks and costs vary.
What Medicare DOESN’T Cover
Custodial stays in a nursing home or assisted living aren’t covered. It’s one of the most common and expensive gaps in Original Medicare coverage.
Routine check-ups, glasses, and hearing aids aren’t covered unless tied to a medical procedure.
You’ll need a separate Part D plan or MA plan for drug coverage.
Except when medically necessary, like diabetes-related foot exams.
Medicare usually doesn’t pay for care outside the U.S., except in rare emergencies.
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