Frequently Asked Questions #3

January 31, 2017

 

Many times, a person who is going on Medicare for the first time will come into our office with the understanding that Medicare will cover any and all medical procedures they have performed.  Today’s FAQs will address some items, services, and procedures Medicare does not cover.    

 

Does Medicare cover all medical procedures?  Medicare doesn’t cover everything.  If you need a service that isn’t covered under Medicare Part A or Part B, you will have to pay for it yourself, unless it’s covered by a supplemental Medicare health plan or Medicaid. The phrase that Medicare uses is “medically necessary.” If you have a procedure performed that is elective and not “medically necessary,” there is a good chance it will not be covered by Medicare.  It is always a good idea to check with your healthcare provider before you have a procedure performed to assure that it is covered by Medicare.

 

What are some examples of items and services not covered by Medicare?  Some items and services not covered by Medicare are:  long-term custodial care, most dental care, eye examinations related to prescribing glasses, dentures, cosmetic surgery, acupuncture, hearing aids and exams for fitting them, and routine foot care.  Also, most prescription drugs are not covered by Medicare.

 

Will Medicare cover me outside the U.S.?  Medicare generally doesn’t cover healthcare while you’re traveling outside the U.S.  There are, however, rare exceptions when Medicare will cover you outside the U.S.  You can find these exceptions in your Medicare and You Handbook or by going to Medicare.gov.  In these rare cases Medicare, may pay for ambulance transportation to a foreign hospital only with admission for medically necessary covered inpatient hospital services.  You pay 20% of the Medicare approved amount, and the Part B deductibles apply.

 

If you have questions regarding any aspect of Medicare or Medicare health plans feel free call us at Alabama Health Guidance (256-648-5710), stop by our office at 885 Florence Blvd (Four Lane Shopping Center), or email me at ikey@alabamahealthguidance.com.  Alabama Health Guidance is an independent insurance agency and is not affiliated with Medicare or any other government agency.

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