Managing Your Care Using Medicare Insurance
Open enrollment period is upon us, and so too are the questions about coverage. As consumers, it can be a challenge navigating the coverages and understanding what items are covered and those that are not. This can be especially confusing when it comes to testing and specialized services.
Medicare coverage for many tests, items and services depends on where you live. Certain items like: chemotherapy, cardiac rehabilitation and disease screenings, glucose control protocols and annual wellness visits, will be covered no matter where you live, which is especially important to “snow birds” as they may seek services in more than one location within any given year. These and many more items may be covered in part, or whole, its’ important to check on your responsibility prior to receiving service.
For example, chemotherapy is covered under Medicare Part A and/or Medicare Part B. Part A covers hospital inpatients, and Part B covers hospital outpatients and patients in a doctor’s office or freestanding clinic. You pay a copayment if you’re a hospital outpatient. You pay 20% of the Medicare-approved amount if you get your treatment in a doctor’s office or freestanding clinic. The Part B deductible applies.
Most importantly, within the first 12-months of enrolling in Medicare PART B, you may attend a welcome visit. You pay nothing for the “Welcome to Medicare” preventive visit or the yearly “Wellness” visit if your doctor or other qualified health care provider accepts assignment. The Part B deductible doesn’t apply.
However, you may have to pay coinsurance, and the Part B deductible may apply if your doctor or other health care provider performs additional tests or services during the same visit. These additional tests or services aren’t covered under the preventive benefits.
There are times when specific tests, services or items are recommended by a physician and are NOT covered under Medicare. If you need certain services Medicare doesn’t cover, you’ll have to pay for them yourself unless:
- You have other insurance that covers them
- You have a Medicare health plan that covers them
Some of the items and services that Medicare doesn’t cover include: Long-term or custodial care, most dental care, eye exams related to prescribing glasses, Dentures, Cosmetic surgery, Acupuncture, Hearing aids and exams for fitting them and Routine foot care. If you are unsure about the coverage of a specific item check the list here.
For more information about Medicare enrollment, coverages or coinsurance options, please schedule a FREE consultation with Marie Brownell at marie@brownellinsurance.com or by calling 603-437-1992.
