Which service is NOT covered by Original Medicare (Parts A and B)?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Original Medicare excludes long-term custodial care — help with the activities of daily living in a nursing facility that requires no skilled medical treatment. Medicare pays for skilled nursing care on a limited, post-hospital basis within a benefit period, but purely custodial care, however lengthy or necessary, is a well-known gap in Medicare coverage. Inpatient hospital care under Part A, physician services including medically necessary home visits under Part B, and hospice care under Part A are all covered benefits. Custodial care is therefore the service that is not covered.
Why the other options are wrong
- B) Inpatient hospital care is the core benefit of Medicare Part A, including semi-private rooms, meals, and skilled nursing services during the hospitalization. Inpatient hospital care is the central Part A benefit, so it cannot be the missing service.
- C) Physician services are covered under Medicare Part B, including medically necessary services furnished in the home when appropriate. Physician services are a Part B benefit and are covered when medically necessary, including in the home.
- D) Hospice care for terminally ill beneficiaries is a covered Medicare Part A benefit, providing palliative rather than curative care at the end of life. Hospice is a covered Part A benefit for the terminally ill, so it is not the gap being tested.
Memory hook
Medicare mends the sick but does not board the frail. Custodial care is the famous Medicare gap.