Original Medicare

Does Medicare cover chiropractors is a common question that we get.  Let’s face it, sometimes alternative types of care work better to relieve pain faster than traditional for some folks.

Eastern medicine has gained a lot of popularity over the past 50 years in the U.S.

It is very common for people to seek out complete health and body treatments from a Chiropractor, Acupuncturist, Yoga instructor, Physical therapist, or Masseuse.

While many people sing the health and healing benefits of these long-practiced medical arts, Medicare is a bit more skeptical and only covers some of their services.

We will look at what Medicare covers for Chiropractic services, Acupuncture, Yoga, Physical Therapy, and Massage.

Does Medicare Cover Chiropractors?

Pain management and health care services come in many forms for many people with Chiropractic Services being a favorite.

If fact, it is estimated that 35 million adults are treated by Chiropractors each year in America.

So it might come as quite a surprise to learn that generally, Chiropractic services are not covered by Medicare.

Of course, just like everything else with Medicare, there is one exception…

Medicare will cover Chiropractic treatments for subluxation, which is a condition where the bones in your spine are out of position.

Subluxation can vary in debilitation and can cause severe joint pain, muscle pain, and cause migraine headaches.

For Medicare to cover your Chiropractic services, your medical doctor must prescribe the treatment.

Medicare Part B will pay 80% of Medicare-approved charges, and you will be responsible for the remaining 20%.

While your doctor and chiropractor may prescribe a lengthy treatment plan, Medicare will only pay for a minimal number of sessions.  So when you ask if “Does Medicare cover Chiropractors?”…the answer is mainly No (unless you qualify under subluxation).

Speak with a Senior Benefits Medicare expert today to find out more.

Does Medicare Cover Acupuncture?

Acupuncture has grown in popularity since coming to the U.S. from China.

Research has shown that it can relieve pain and nausea by helping the flow of energy, called ‘qi’.

Skilled professionals are able to help that flow by inserting metallic needles into the skin with the intent of relieving pain or other ailments.

Scientists are unsure how it works, however, many studies have shown acupuncture to be very effective in treating health issues, such as:

• Lower back pain
• Headaches
• Osteoarthritis
• Nausea

Because of these benefits, it makes sense to combine this treatment with others if you feel it is effective.

However, Medicare does not believe that acupuncture is ‘Medically Necessary’ for most treatments other than chronic lower back pain.  Chronic low back pain is defined as:

• Lasts 12 weeks or longer
• Has no known cause (for example it is not related to another known disease, infection, etc)
• Is not associated with a surgery or preganancy

Now that you know that Medicare will cover acupuncture for chronic low back pain, it is important to go see the right provider.  Medicare states that you must get acupuncture from a health provider that has both of these:

• A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine
• A current, full, active, and unrestricted license to practice acupuncture in the state where you’re getting care

So what does Medicare pay for acupuncture?

Medicare will cover up to 12 acupuncture treatments in 90 days for chronic low back pain (see definition above).  If you show improvement then Medicare will pay for an additional 8 sessions.  You can get a maximum of 20 acupuncture treatments in a 12-month period.

What if you don’t show improvement at 12 treatments?

You will be responsible for 100% of your additional acupuncture treatments after the original 12 treatments.

Does Medicare Cover Physical Therapy?

Medicare B covers medically necessary outpatient therapy.

In previous years Medicare put a cap on how much physical therapy they would pay in a calendar year.

However, as of 2019, there is no longer a cap on how much they will pay for medically necessary PT.

Keep in mind that you can receive up to $2,040 in physical therapy a year before having to provide a note from your doctor saying it is medically necessary.

Original Medicare Part B covers 80% of Medicare-approved costs, and you will be responsible for the other 20% unless you have supplemental insurance.

To help offset the costs of Original Medicare, you can purchase Medigap plans that can cover some or all of the additional expenses Medicare does not.

Speak with a Senior Benefits Medicare expert today about your health care options.

Does Medicare Cover Yoga?

While fitness and exercise play a large role in your overall health, Original Medicare does not cover yoga, fitness programs, or gym memberships.

To get coverage for exercise programs, you will need to get additional coverage from a Medicare Supplement Plan.

Many supplements include gym memberships and access to programs like Silver Sneakers. 

Yoga has been proven to have tremendous health benefits and reduces your chance of injury in the event of a fall.

Contact a Senior Benefits expert to discuss enrolling in a supplement plan that includes yoga coverage.

Does Medicare Cover Massage?

Technically, Medicare does not cover massages because it is considered an alternative therapy. 

As an alternative therapy, it is not deemed medically necessary, and so, it is not included.

But, I did say ‘technically’ because if you are receiving physical or occupational therapy, one element of those sessions is a massage. 

The reason Medicare doesn’t cover therapeutic massage is that it is considered alternative or complementary medicine.

According to the Affordable Care Act, massage therapy isn’t defined as an essential benefit or widely accepted medical practice.

Therefore, it is very difficult to justify treatment from an insurance standpoint.

Take Action!  

Now you are armed with information about the various therapy coverages Medicare provides and can plan accordingly.

Many of these services can be covered by alternative health insurance plans or supplemental plans.

Contact a Senior Benefits Medicare expert today to discuss all of your options at (800)924-4727

Medicare Preventive Services

It can be confusing trying to understand what Medicare preventive services will covered and what will not!

However, there is no confusion when it comes to Preventive Services because Medicare covers that!

If you are unsure what Preventative Services are covered, you can click here.

As a Senior Benefit Services value-added service, you can always contact us to help with any coverage questions and/or get a free quote.

The One Thing That is Not Covered Will Shock You

Believe it or not, Medicare does not cover yearly Physicals. While you do get a Welcome To Medicare physical, this is only covered once.

How To Still Get Your Health Check-Up Each Year

The Annual Wellness Visit is an appointment with your primary care provider, during which they will update your prevention plan. The purpose of the appointment, after all, is to help you prevent sickness based on your health status and any risk factors you may have.  While it is not quite as in-depth as a full physical, it does provide the following:

• Routine measurements
• Height, weight, and blood pressure check
• Health risk assessment consisting of questions about your healthcare status, needs, and risks
• Review of medical history and family medical history
• Review your list of current medications
• Assessment of your functional ability and mobility.  This will help determine if you are able to handle your tasks of daily living like eating, bathing, transferring, and dressing
• Screenings for hearing issues, dementia, and depression

Keep in mind that the Annual Wellness visit is covered 100% by Medicare and can only be conducted every 12 months.

What Other Preventive Services Are Covered by Medicare?

Medicare covers a wide range of preventive services to help you stay healthy and detect potential health issues early. Here’s a list of some of the key preventive services covered under Medicare:

1. Annual Wellness Visit: This visit includes a review of your medical and family history, a list of current providers and prescriptions, height, weight, blood pressure measurements, and a personalized prevention plan.
2. Cardiovascular Screenings: Medicare covers blood tests to check cholesterol, lipid, and triglyceride levels every 5 years.
3. Cancer Screenings:
   • Breast Cancer (Mammograms): Medicare covers screening mammograms once every 12 months for women aged 40 and older.
   • Cervical and Vaginal Cancer (Pap Smear and Pelvic Exam): These are covered every 24 months, or every 12 months if you’re at high risk.
   • Colorectal Cancer: Coverage includes screenings such as fecal occult blood tests, flexible sigmoidoscopy, and colonoscopy.
   • Prostate Cancer: Medicare covers a prostate-specific antigen (PSA) test once every 12 months for men aged 50 and older.
4. Diabetes Screening and Services: Medicare covers tests for people at risk of diabetes and self-management training for those diagnosed with diabetes.
5. Flu Shots: Medicare covers one flu shot per flu season.
6. Hepatitis B Shots: This series of shots is covered for those at medium or high risk.
7. Hepatitis C Screening: Covered for people at high risk, including those with a history of illicit drug use and recipients of blood transfusions before 1992.
8. HIV Screening: Medicare covers this test once every 12 months or up to three times per year during pregnancy.
9. Lung Cancer Screening: Annual screening with low-dose computed tomography (LDCT) for people aged 55-77 who have a history of heavy smoking.
10. Obesity Screening and Counseling: Medicare covers screenings and behavioral counseling to help you lose weight.
11. Pneumococcal Shots: Medicare covers pneumococcal vaccines to prevent certain types of pneumonia.
12. Smoking Cessation Counseling: If you use tobacco, Medicare covers up to 8 face-to-face visits per 12-month period.
13. Bone Density Test: Medicare covers bone mass measurements to see if you’re at risk for broken bones.
14. Depression Screening: An annual screening for depression is covered.
15. Alcohol Misuse Screening and Counseling: Medicare covers one alcohol misuse screening per year and counseling sessions if you’re determined to be misusing alcohol.

These preventive services are designed to help detect potential health problems early, when treatment is most likely to be effective. It’s important to take advantage of these services to maintain your health and well-being.

Take Action!

Senior Benefit Services has expert agents standing by to to help you with your understanding of Medicare, or guide you thru obtaining important Medicare Supplemental or Medicare Advantage Plans.  Call (800)924-4727 to get the help you deserve.

You can also get a free Medicare Supplement quote by completing the form below.

Is Medicare tax deductible? This is one of the biggest questions those who are retired or getting ready to retire ask us.

The Internal Revenue Service (IRS) provides American citizens with the opportunity to deduct various personal expenses from their taxable income each year. However, it is important to understand that not all regularly incurred expenses are eligible for deduction, as the Internal Revenue Code specifies certain criteria for deductibility.

Federal deductions play a crucial role in reducing the amount of income subject to federal income tax, which ultimately lightens the tax burden during tax season. Consequently, many American citizens, including Medicare beneficiaries, seek out suitable tax deductions to maximize their tax returns.

For Medicare beneficiaries, it is natural to wonder which Medicare-related costs can qualify for a tax break.Optimize your Medicare-related tax deductions and maximize your tax return by staying well-informed.

So, is Medicare tax deductible?

The answer is a resounding yes! Medicare premiums are indeed tax-deductible, but there is a threshold to consider.

In order to deduct your Medicare expenses from your taxes, the total amount of your deductible medical and dental expenses must exceed 7.5% of your adjusted gross income (AGI). If you meet this requirement, you will need to complete Schedule A of Form 1040.

The deductible amount is subtracted from your gross income, ultimately determining your taxable income and guiding your tax obligations.

Tax Deductible

Medicare premium tax deductions extend beyond Original Medicare, importantly. If your total medical and dental deductions exceed 7.5% of your gross income, you can also deduct premiums for Medicare Part A (if applicable), Part B, Part D, Medicare Advantage, and Medicare Supplement (Medigap) plans.

Tax Deductible for the self-employed?

Now, let’s talk about tax-deductible Medicare premiums for the self-employed. If you earn income from self-employment and are enrolled in Medicare, you have the opportunity to deduct the entire cost of your Medicare premiums from your taxable income. Additionally, if your spouse is also a Medicare beneficiary, you can deduct their Medicare premium costs as well.

To qualify as self-employed according to IRS standards, you must fall into one of the following categories:

• Sole proprietor or independent contractor engaged in a trade or business
• Member of a partnership involved in a trade or business
• Otherwise operating as a self-employed individual

By following these guidelines, you can ensure that you are maximizing your Medicare-related tax deductions while staying compliant with IRS regulations.

Deductible Medicare Expenses: Understanding What You Can Claim

When it comes to tax deductions, not all Medicare expenses are eligible. But don’t worry, we’re here to shed light on what you can and can’t claim, helping you navigate the world of medical expenditures.

Let’s start with the good news – Medicare premiums are indeed tax-deductible. According to the IRS, these premiums fall under the category of medical expenses, making them eligible for deduction. However, it’s important to note that only itemized deductions on personal income tax returns qualify for this benefit.

But wait, there’s more! The scope of deductible expenses extends beyond premiums. You can also claim costs related to the treatment, diagnosis, and prevention of medical conditions or injuries. This includes the expenses for necessary medical equipment, supplies, and even preventive care.

For a full list of medical and dental expenses that are approved in 2022 by the IRS for deductions can be found here. Feel free to review the draft of 2023 approved medical and dental expenses.

What is a deductible expense?

Now, you might be wondering, what exactly qualifies as a deductible medical expense? To make things crystal clear, the IRS has provided a comprehensive list for reference. It’s always a good idea to consult their list to ensure you’re making the most of available deductions.

Here’s an interesting tidbit – there are often overlooked items on the medical expenses list. You can also claim the cost of modifying your home to accommodate medical equipment. Yes, it’s true! Transportation costs can also be eligible for deduction, so keep that in mind.

Honorable Mention

Most Medicare beneficiaries, often retirees, are 65 years of age or older. Consequently, their adjusted gross incomes (AGIs) tend to be lower. This means that deducting Medicare premiums from taxes can be particularly advantageous for the average recipient.

So, as you prepare your taxes, keep these deductible Medicare expenses in mind. Ensure to maximize your benefits and take advantage of all entitled deductions. The information provided above is not tax advice but rather suggestions of areas you should speak with your tax preparer about to see if you can qualify for any deductions.

Takeaway

While deductions are always great, it is very important to make sure you have the right Medicare coverage for your health and budget needs. Call Senior Benefit Services, Inc. at (800)924-48727 to speak to one of our advisors to make sure you are in the correct plan that offers the lowest premiums, and the correct benefits for your needs.

Prefer us to contact you? Simply click on the button below and give us a little bit of information and we will have an advisor reach out to you ASAP!

The Centers for Medicare & Medicaid Services (CMS) released the Medicare costs for 2024. Find out more about what Medicare costs for you in the new year.

Medicare Part A Costs 2024

Medicare Part A is designed to help cover the costs of such things as inpatient hospital care and skilled nursing facility care. So lets take a look at what Medicare Part A costs in 2024.

• Medicare Part A Deductible will rise to $1632 which is an increase of $32
• Medicare Part A coinsurance for inpatient hospital stays that last more than 60 days will have a daily co-payment amount of $408 beginning on day 61 thru day 90 which is an increase of $8 per day.
• Medicare Part A coinsurance for inpatient hospital stays that last more than 90 days will have a daily co-payment amount of $816 beginning on day 91 thru day 150 which is an increase of $16 per day.
• Skilled Nursing Facility daily coinsurance will be $204 per day beginning on day 21 thru day 100. The daily co-payment is an increase of $4 per day.

The Medicare Part A premium has risen as well. Keep in mind that the majority of American retirees do not pay a Part A premium since they have worked at least 40 quarters of Medicare covered employment. For those who did not work enough quarters for premium-free Part A, their costs are as follows:

Common Part A Questions

1. Is the Medicare Part A deductible an annual deductible? No, the Part A deductible can be charged more than once per year. You will be responsible for the Part A deductible for each benefit period (per occurrence) of inpatient hospital care. The benefit period restarts after you have not received any inpatient hospital care for at least 60 days in a row.
2. Is there a limit as to how benefit periods a person can have in one year? No.
3. Are there benefit periods for Skilled Nursing Facility (SNF)? Yes, a benefit period begins the day you are admitted as an inpatient and ends after you have not received any skilled care in a SNF for at least 60 days in a row.
4. Want to view more commonly asked questions about Medicare Part A? Click here.

Medicare Part B Costs 2024

Medicare Part B is designed to help cover medical costs such as doctors, surgeons, outpatient surgery some prescription drugs, and so much more. So lets take a look at what Medicare Part B costs in 2024.

• Medicare Part B deductible will rise to $240 which is an increase of $14
• Medicare Part B coinsurance will remain at 20%

The Medicare Part B premium has risen as well. For those individuals who are not classified as high income earners, the Medicare Part B premium will rise to $170.70 per month which is an increase of $5.80 per month.

If you are classified as a high income earner you will pay a Medicare Income-Related Monthly Adjustment Amount (IRMAA). It is important to keep in mind that this classification is based off of your IRS tax return from 2 years ago (which may be unknown to many that are new to Medicare). The additional premium you would pay each month for Medicare Part B in 2024 based on your yearly income in 2022 would be as follows:

Common Part B Questions

1. Is the Medicare Part B deductible an annual deductible? Yes.
2. What are Medicare approved amounts? This is the payment amount that original Medicare sets for a specific covered service or item.
3. If I am classified as a high income earner due to my tax returns but I don’t make that much income anymore, can I file an appeal? If you had a life changing event such as death of a spouse, marriage, divorce or annulment, work reduction, work stoppage, loss of income from producing property, loss or reduction of certain kinds of pension income then you can file an appeal. Other situations that would warrant an appeal would be such things as there being an error in the IRS data, the IRS provided older data and you have newer information available that shows lower income, or you filed an amended tax return for the year that the Social Security Administration (SSA) is using to make their classification of you being a higher income earner.

Takeaway

The overall increases released for 2024 are not the worst we have seen, but still will affect the net income a retiree will have each month. The Medicare Part B monthly cost for 2024 will be about 3.5% higher which will basically mirror the 2024 Social Security increase for 2024 of 3.2%. Call us at (800)924-4727 to check if you can reduce your current Medicare Supplement plan premium or to explore if a Medicare Advantage plan suits you better. One of our knowledgeable advisors will assist you. Prefer to have us call you, then simply click on the box below and provide us with your contact information.