What Does Medicare Actually Cover? A Simple Breakdown for New Enrollees in Indiana

Richie Insurance Solutions
May 5
3 min read

Can I keep my doctor with Medicare Advantage in Indiana?

If you're new to Medicare, you might be feeling a little overwhelmed by all the parts, plans, and paperwork. You're not alone—and that's exactly why we’re here.

At Richie Insurance Solutions, based right here in Kokomo, Indiana, we help Hoosiers all across north central Indiana understand their Medicare options so they can make confident, informed decisions. Whether you're approaching age 65, helping a loved one, or navigating Medicare due to a disability, this guide will break down what Medicare actually covers—without the jargon.

The Four Parts of Medicare Explained

Part A – Hospital Coverage

Think of Part A as your hospital insurance. It helps cover:

Inpatient hospital stays
- For example: If you’re admitted overnight for surgery or treatment after an emergency. This includes room, meals, and necessary nursing care.
Skilled nursing facility care
- Often needed for short-term rehab after a hospital stay—like recovering from a hip replacement or stroke. This is not long-term custodial care.
Hospice care
- For individuals facing a terminal illness, this covers comfort care, pain management, and support for families at the end of life.
Some home health care services
- If your doctor orders part-time nursing or therapy at home after a hospital stay or injury.

Most people don’t pay a premium for Part A if they or a spouse paid Medicare taxes during their working years.

Part B – Medical Coverage

Part B helps cover medical services outside of the hospital, like:

Doctor visits
- For regular check-ups, follow-ups, and specialists like cardiologists or dermatologists.
Lab work and X-rays
- Think blood tests to monitor cholesterol or X-rays to check for a broken bone.
Outpatient services
- Includes things like same-day surgery, physical therapy, or visits to a pain management clinic.
Preventive care
- Such as flu shots, cancer screenings, diabetes checks, and annual wellness visits—all aimed at keeping you healthy.
Durable medical equipment (DME)
- Includes wheelchairs, walkers, oxygen tanks—tools you may need to live safely at home.

There is a monthly premium for Part B, which may vary depending on your income.

Part C – Medicare Advantage

Medicare Advantage Plans are offered by private insurance companies and combine the benefits of Parts A and B—often with extras. Most plans include:

Prescription drug coverage
- Covers your routine medications, like heart or blood pressure drugs.
Vision and dental benefits
- Covers eye exams, glasses, cleanings, and sometimes dentures or hearing aids.
Hearing care and fitness benefits
- May include hearing tests and devices, plus SilverSneakers gym memberships.

These plans often have $0 premiums and include local networks of doctors and hospitals. For example, many Kokomo-area plans offer full access to Howard Community Hospital and area clinics.

You must still pay your Part B premium when enrolled in a Medicare Advantage plan.

Part D – Prescription Drug Coverage

Part D helps cover the cost of prescription medications. You can:

Enroll in a stand-alone Part D plan if you have Original Medicare
Or choose a Medicare Advantage plan that includes drug coverage

Covered drugs vary by plan, but many include:

Common medications like cholesterol meds, inhalers, or diabetes supplies
Preferred pharmacy options (like CVS, Walgreens, or locally owned pharmacies)

Plans have tiers, copays, and sometimes deductibles—so it’s important to review options carefully.

What About Gaps in Coverage?

Even with Original Medicare, there are still out-of-pocket costs like deductibles, copays, and coinsurance. That’s where a Medicare Supplement (Medigap) plan comes in.

These plans help cover the "gaps" in Original Medicare.
For example, they may cover a hospital deductible or 20% coinsurance from a doctor visit.
You can see any provider nationwide who accepts Medicare—ideal if you travel or split time between Indiana and another state.

You must have Parts A and B to enroll in a Medigap plan.

Local Medicare Advantage agent in Indiana

Local Help Makes a Big Difference

Medicare isn’t one-size-fits-all. The plans available in Kokomo, Tipton, Peru, Logansport, Greentown, and across north central Indiana vary in terms of benefits, doctor networks, and costs.

That’s why working with a local, independent agent like Lauren Richie at Richie Insurance Solutions can save you time, money, and frustration. We know which plans work best for area hospitals and doctors—and we’ll walk you through the details with patience and care.