You are driving home from work and remember that you need to check the mailbox. When you get home you open the box and pull out the mail, you glance at an envelope and discover that it’s a medical bill. Your stomach becomes uneasy and your hands start to shake. You open it, then discover that the bill is much more than expected. You have no clue how you are going to pay it. You start asking yourself the age old question “Why did Medicare not cover this?”
This happens to many people who are not aware of what Medicare will or will not cover. There are many things that Medicare Part A and B will not pay for. Listed below are some of the most common misconceptions.
Alternative Medicine: These consist of any practices that result in the healing effects of medicine, but does not originate from evidence gathered using the scientific method. This includes a wide variety of health care practices, products and therapies. Examples include homeopathy, naturopathy, chiropractic, energy medicine, and acupuncture. Medicare will not cover these type of treatments unless it’s medically necessary to correct a misalignment of the spine.
Cosmetic Surgery: Medicare won’t cover cosmetic surgery, unless it is medically required due to an injury or to improve functionality of a deformed body part. If you are a breast cancer patient who has had a mastectomy, Medicare will cover breast prostheses.
Dental Care: Medicare Parts A and B do not cover most routine dental checkups and supplies. This includes dentures, oral exams, cleanings, extractions, fillings, and root canals (unless the dental service is necessary for treating a covered procedure).
Hearing Care: Medicare Parts A and B will not cover routine hearing exams, hearing aids, and exams to get fitted for hearing aids. However, if your doctor orders a diagnostic hearing exam to see if you need further treatment you may be covered.
Vision Care: Medicare Parts A and B will not cover most routine vision care and supplies, including eye exams, glasses, contacts, and exams to get fitted for contacts and glasses. Medicare Part A may cover certain vision benefits if they’re related to treatment, such as corrective lenses or glasses following a covered cataract surgery. Medicare Part B will cover preventive or diagnostic eye exams, such as glaucoma screenings if you’re at high risk.
Prescription Drugs: Medicare Parts A and B, do not include prescription drug coverage. This must be purchased separately under Medicare Part D if you need this type of coverage. However, Medicare Part A will cover drugs administered during a stay in a hospital or skilled nursing facility. Medicare Part B may cover drugs that are administered in a doctor’s office, for example vaccines and chemotherapy.
Long-term Care: Medicare doesn’t cover long-term or nursing home care. However, Medicare does cover short-term nursing care when it follows a qualifying inpatient hospital stay. Medicare Part A may cover nursing care in a skilled nursing facility for a limited time if it’s medically necessary for you to receive skilled care, such as rehab. However, Medicare won’t cover nursing home stays if personal care is the only care you need.
As you can see there are many things that are not covered under Medicare Parts A and B. It would be worth your while to check into Medicare Part D if you have many prescriptions, as well as Medicare Advantage plans. Medicare Advantage plans will help cover extra health care costs that Medicare Parts A and B do not cover. No one likes to be caught off guard by a hefty medical bill, so make sure to do your research and find out which plan will work best for you. If you have any questions, please contact us at (615)-541-4257 and we would be happy to connect you with an agent.