Things That Are Covered By Medicare Plans

Medicare covers a plethora of medical services and medical facilities, but one needs to be careful before choosing a Medicare plan as every plan comes with their own set of tests, services, plans etc. It is important to have an open discussion with one’s doctor and insurance agents in Wheaton to know about what types of coverage are required at a certain age and if one has any medical condition. Medicare coverage also changes from place to place so one should have all the required information before settling for one.

One can get their coverage in two ways, that is, by enrolling either in original Medicare plan, including Part A and B or in Medicare Advantage Plan of Part C. One can also choose additional coverage like prescription drug coverage, supplement insurance, which will add different benefits to the Medicare plans.

One will find different medical services and facilities that will be covered by different plans.

Coverage by Part A

If one is enrolled in original Medicare plan Part A, then there are some things that will be covered by this plan, and some that will be covered only in certain situations or when patients have certain conditions. Part A covers:

·         Inpatient hospital care when one is admitted on doctor’s orders. This includes or covers meals and semi-private rooms, general nursing, and drugs which are part of the treatment.

·         Skilled nursing care when one is admitted to an SNF for a short term. The facilities included are semi-private rooms, skilled nurse care, meals, physical and speech-language therapy if needed, medications, ambulance, dietary counseling.

·         Long term hospital care in a LTCH which involves medical conditions that are to be treated for longer periods that is more than 25 days.

Coverage by Part B

Part B necessarily covers two types of medical services. Firstly, it covers necessary services for diagnosing and treating a condition, and secondly, it covers preventive services. Different facilities covered by Part B are:

·         Clinical researching when one wants to join a study to learn more about a disease or illness.

·         Ambulance services which, when needed in the case or emergency transportation to the hospital, SNF etc. It also covers air ambulance services in case of unavailability of ground transportation services.

·         Mental health services for outpatients, inpatients, and partially hospitalized patients.

·         Durable medical equipment if doctors have prescribed them to be used at home. The equipment like canes, commode chairs, blood sugar strips and monitors, crutches, CPAP devices, hospital beds etc.

·         Charges of the second opinion from a different doctor before any major surgery is also covered by this.

Coverage by advantage plans

They cover almost everything that is covered by the original Medicare plan. Advantage plans involve health maintenance organization plans, preferred provider organization plans, special needs plans and private fee for service plans. With advantage plan, there will be many added benefits which cover everything that is needed for rapid and urgent medical care.

There are many services that are not covered by Medicare plans and one should know about them too. Some of them are like custodial care, eye exams, dentures, foot care, acupuncture etc.