Most seniors believe that their Medicare A or Part B plus coverage includes all Medicare-approved services and treatments. Unfortunately, some of the most costly medical needs are not covered. Read the following list of Medicare exclusions to ensure that you or a loved one does not have to pay out of pocket.
Most insurance policies do not cover hearing aids or audiologist services, which can cost thousands of dollars. Hearing loss affects one out of every three people over the age of 70, and nearly half of those over the age of 75 have difficulty hearing.
Unless you have an emergency or require a complicated procedure, dental care is not included. Dentures, which can cost between $1,000 and $5,000 for a full set, are not included. Tooth implants, which typically cost around $4,000 per tooth, are not included. Routine cleanings, X-rays, fillings, and dentures are also not covered by Medicare.
Also Read: Does Medicare Cover Dental Implants?
In most cases, vision care is not covered by insurance. Only the eye exam is covered by Medicare if you need glasses. Insurance does not cover both the testing for corrective lenses and the glasses themselves. The first pair of glasses after cataract surgery, on the other hand, is covered. Only basic lenses and a low-cost frame are covered in this case. Bifocals and transition lenses are not covered by Medicare.
Treatment for glaucoma, cataracts, and other eye diseases is covered, but medications are not unless you have a prescription drug plan. Contact lenses and LASIK surgery to correct vision are also not covered.
Also Read: Does Medicare Cover Cataract Surgery?
Admissions to hospitals must be properly coded. Medicare will not pay for your hospital stay if you are admitted to a hospital for observation. Make certain that you are admitted for treatment rather than observation. Stays in a rehabilitation hospital or center are not covered unless you have been a regular hospital inpatient for at least three days.
In general, health care received while traveling outside of the United States is not covered. Treatment is available in the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. In extremely rare circumstances, Medicare will pay for inpatient hospitalization, doctor visits, ambulance services, or dialysis in a foreign country.
Some low-income individuals may be eligible for programs that reduce their Medicare-related costs. Prescription drug coverage receives additional assistance, and some state-run savings programs can assist with copays, coinsurance, deductibles, and premiums. Those who do not qualify must pay out of pocket or purchase additional insurance. If you choose an Advantage Plan, you can expect dental and vision coverage to be included. It will, however, most likely be limited.
Also Read: Medicare Plan Terms Employers Need to Know
Unfortunately, except for some advantage plans, Medicare usually does not include a medical alert system, so you will have to take care of that on your own.
Medicare and other health insurance options for seniors can be complicated, so hopefully, we were able to answer some of your questions.
Medicare is covered only by home health care services prescribed by a physician and delivered by qualified nurses, although patients must meet strict eligibility criteria.
What is the easiest way to apply for Medicare? Well, you are in the right place! Most people were automatically enrolled and became eligible for Social Security when they turn to 65. We didn't need to apply for Medicare until President Reagan signed the legislation which raises the retirement age in 1983 and begins in 2003.
While eye care is a common need as we age, Medicare coverage is extremely restricted for most vision services. It is normally based on whether you encounter any medical problems that can impair your eyesight.
Many people believe that Medicare is free because, for much of their working life, you have paid into Medicare by taxes, but that assumption is not right.
Often, Medicare premiums come as a shock to new Medicare recipients. You may have noticed that the federal government has been deducting taxes for years from your paychecks. And yes, these deductions go into paying your future payments for Medicare Part A as well as your income checks from Social Security.