Table: Who Pays for What? - Merck Manuals Consumer Version

Health Topics & Chapters

Who Pays for What?

Who Pays for What?

Type of Care	Services	Covered by
Hospital care*	Inpatient care, including mental health care General nursing and other hospital services and supplies Drugs used during hospitalization A semiprivate room (a private room only if medically necessary) Meals	Medicare Part A Medicare Part C (Medicare Advantage) Medicaid Department of Veterans Affairs (VA)†
Short-term care in a certified skilled nursing facility (nursing home)	Skilled nursing care Social services Drugs used in the facility Medical supplies and equipment used in the facility Dietary counseling Physical, occupational, and speech therapy (if needed) to meet the person's health goals Transportation by ambulance (when other transportation endangers health) to the nearest facility providing needed services unavailable at the skilled nursing facility A semiprivate room Meals	Medicare Part A if people need short-term care temporarily after a hospital stay Medicare Part C if people need short-term care temporarily after a hospital stay Medicaid VA†
Outpatient care	Doctor’s, nurse practitioner’s, and physician assistant’s fees, including for certain telehealth services (real-time remote office visits and consultations) Emergency department visits Transportation by ambulance (when other transportation endangers health) Outpatient surgery (with no overnight stay in the hospital) Rehabilitation (physical, occupational, and speech therapy) Diagnostic tests, such as x-rays and laboratory tests Outpatient mental health care Outpatient dialysis A second opinion if surgery is recommended and a third opinion if opinions differ For people with diabetes, diabetes supplies, self-management training, eye examinations, and nutrition counseling Smoking cessation Durable medical equipment, such as wheelchairs, hospital beds, oxygen, and walkers	Medicare Part B Medicare Part C Medicaid VA†
Home health care	Personal care, including help with eating, bathing, going to the bathroom, dressing Part-time skilled nursing care Physical, occupational, and speech therapy Home health aide services Social services Medical supplies, such as wound dressings, but not prescription drugs	Medicare Part A if people are homebound and need part-time skilled nursing care or rehabilitation on a daily basis Medicare Part B Medicare Part C Medicaid VA†
Preventive care	Screening tests for breast, cervical, colorectal, lung, prostate, and vaginal cancer Screening tests for abdominal aortic aneurysm, depression, hepatitis B and C, HIV, elevated cholesterol Screening and counseling for alcohol misuse, cardiovascular disease, diabetes, obesity, sexually transmitted infections, tobacco use Bone density measurements Glaucoma tests Influenza, pneumococcal, and hepatitis B vaccinations One-time Welcome-to-Medicare preventive visit Yearly wellness visit (includes voluntary advance care directive preparation) Nutrition therapy services	Medicare Part B Medicare Part C Medicaid VA†
Extra benefits	Prescription drugs Eyeglasses Hearing aids	Medicare Part C Medicare Part D (prescription drug plans) Medicare Part B (limited outpatient prescription drugs) Medicaid in some states VA†
Long-term care in an assisted living community	Varies greatly from community to community Meals Help with daily activities Some social and recreational activities Some health care	Medicaid in a few states (partial coverage) VA† in some situations
Long-term care in a skilled nursing facility (nursing home)	Varies from state to state	Medicaid VA†
Hospice care	Physical care and counseling Room and meals only during inpatient respite care and short-term hospital stays	Medicare Part A Medicare Part C
* Medicare Part A covers care in long-term care hospitals for people who may have more than one serious condition and be expected to improve and return home. † For the Veterans Administration (VA), the rules of eligibility vary for different services and change frequently.