Medicare basics

The main parts of Medicare

Most people interact with Medicare in one of two broad ways:

• Original Medicare (Parts A and B) – hospital (A) and medical (B) coverage. Often paired with a Part D drug plan and sometimes a Medigap supplement.
• Medicare Advantage (Part C) – private plans that bundle hospital, medical, and often drug coverage, with their own networks and rules.

In simple terms:

• Part A – inpatient hospital, limited skilled nursing facility stays, some home health, hospice.
• Part B – doctor visits, outpatient care, tests, some equipment.
• Part D – prescription drug plans (standalone with Original Medicare, or included in many Advantage plans).

What Medicare usually does not cover

Families often assume Medicare will pay for things it generally does not cover. Common examples:

• Long-term residence in assisted living or memory care.
• Long-term custodial care in a nursing home (help with daily activities without ongoing skilled needs).
• Most non-medical home care (companionship, housekeeping, transportation, meal prep).

Medicare may pay for short periods of skilled care after a qualifying hospital stay, but that is not the same as permanent long-term care coverage.

Short-term rehab coverage: common confusion

After a hospital stay, someone may go to a skilled nursing facility for rehabilitation. Key points:

• Coverage depends on specific rules (for example, type and length of the hospital stay, medical need for skilled care).
• Coverage is often structured in “days,” with changing cost-sharing over time.
• If the person is there mainly for “custodial” care, Medicare coverage may be limited or not apply.

This is one of the most confusing transitions. Asking early, “How is this stay being billed?” and “What happens when rehab ends?” can prevent nasty surprises.

Questions to ask plan representatives or counselors

When you talk to Medicare, a plan, or a counseling program (like SHIP), it can help to ask:

• “In our situation, what types of care are typically covered — and what usually isn’t?”
• “If we chose [assisted living / home care / nursing facility], what would Medicare pay for, if anything?”
• “How do rehab days, deductibles, and copays work for us this year?”
• “Are there local counseling programs that can walk through our specific options?”

How this fits with other Learn pages and tools

Medicare is one piece of the picture. To understand how it interacts with housing, family workload, and medications, you can:

• Read the Learn pages on assisted living, staying at home, and nursing facilities.
• Use the Tools page to compare “stay vs. move” scenarios and map costs and roles.
• Pair this information with conversations with local professionals who know your state’s rules.