Medical Services Not Covered by Original Medicare

Are there medical services not covered by Original Medicare? Yes there are, but lets review what the different types of services it does cover first. 

Part A Coverage

There are several benefits to Medicare Part A, sometimes referred to as hospital insurance. It covers services such as hospitalization rehabilitation, and types of home healthcare. It’s best practice to consider getting a supplemental insurance along with Medicare Part A because most services have a steep co-pay.

Part B Coverage

The cost of Medicare Part B covers mainly outpatient treatments such as routine visits to the doctor and outpatient chemotherapy for cancer. Again, it’s wise to get a supplemental insurance to avoid co-pays which can run up to 20 percent of the total bill. 

Part D Coverage

Part D Medicare pays for most prescription medicine. Some plans do not cover non-generic brands. Other plans do cover brand name medication. All of the Part D plans cover a long list of prescriptions for illnesses and injuries, but each plan has a different formulary. In order to get the most out of Medicare Part D, discuss your prescriptions with your doctor or pharmacy and ask their advice about getting an inexpensive plan that covers most of your medicines. It’s important to understand what Medicare Part A or Medicare Part B doesn’t cover.

Medical Services Not Covered by Original MedicareMedical_Services_Not_Covered_by_Original_Medicare

Medicare Part A will pick up part of the expenses for a person getting physical, occupational or speech therapy at home or in a facility. However, Medicare coverage stops if your condition worsens or stops getting better.

At that point if you need to be safe at home with hired home care, or move into an assisted living or nursing home, these services are not covered by Medicare. You’ll have to pay for them with long term insurance, out of pocket or through the state’s low-income assistant page, often called Medicaid.

It doesn’t cover a private room at the hospital or a cosmetic procedure. One exception might be if you’re in a private room due to a contagious illness.

If you had a stroke or a heart attack, or you survived a serious car crash and your condition is critical, Medicare will pay. They will not pay for someone who has a a non-emergency medical condition like a sprained ankle or a dog bike.

Finally, Part A & Part B usually decline to pay for medical care delivered outside the US. This means that if you’re traveling abroad and get sick, you”ll be responsible for your medical care. If you plan on traveling abroad you might want to consider paying for travel insurance. 

Medicare Part B doesn’t cover prescription and non-prescription medications. Medicare Part D can help with the cost prescriptions, all Part D plans are slightly different. Pick your plan carefully so that you’ll have the lowest possible co-pays.

With outpatient cosmetic clinics popping up around the United States, many people assume that cosmetic procedures will be covered by Medicare Part B. Medicare will cover Botox if it’s used to treat illness and not for the sole purpose of changing appearance.

It also doesn’t cover vision, hearing or dental procedures or any alternative treatments, with the exception of acupuncture and chiropractic work in some cases.

For more information please don’t hesitate to call one of our live agents or fill out the compare rates form today to receive a quote. 

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