The list of coverages that Medicare provides for Part A and Part B seems endless. Unfortunately, it is not.
Knowing what does Medicare not cover can help you avoid being stuck with some costly medical bills.
Luckily, Medicare offers a free search tool to see if Medicare does or does not cover the treatment.
But wait, we’ve already done that for you too!
Inside you will find the ultimate list of ‘What does Medicare not cover’!
What Does Medicare Part A Not Cover
Medicare Part A is the covers your inpatient hospital stays.
Generally, these coverages include hospital related treatments, and sometimes on a limited basis, some home health services.
While in the hospital, Part A covers, semi-private rooms, prescriptions, food, and nursing care so long as it is part of your inpatient care.
However, Medicare Part A does not include private rooms (unless medically necessary), private nurses, or your toiletry items, like toothpaste, deodorant, or shampoo, etc.
You will also have to pay for the first three pints of blood if the hospital has to purchase it. If it is received as a donation from a blood bank or was donated by you or a friend, there will be no extra charge.
Medicare Part A covers just about anything you would need medically if you stay overnight.
Most of the services and treatments that are not covered tend to be things that Medicare Supplements will cover.
Contact a Senior Benefits agent today to discuss getting coverage where there presently is none.
What Does Medicare Part B Not Cover
Your Medicare Part B coverage kicks in when you visit the doctor or use hospital services in an outpatient capacity.
These services include routine medical checkups, x-rays, mammograms, prostate exams, and things like preventative blood work.
However, Part B does not cover things that are not medically necessary.
Medically necessary is a term you will hear a lot when discussing Medicare coverages.
What it means is that procedures and services such as cosmetic surgeries or alternative medicines, like acupuncture or massage, will not be covered because they are not medically necessary.
Some of the bigger surprises that Medicare does not cover are; prescription drugs that are taken at home, eye and hearing exams, most dental work, and long term care.
Medicare Part B pretty much abandons care for your eyes and hearing. They will not cover eyeglasses or hearing aids, which is a large reason so many people turn to Medigap supplemental insurance.
You can purchase Medicare Supplemental insurance to cover most of these type of treatments and services.
Contact a Senior Benefits Medicare Expert today!
Ultimate List Of What Medicare Does Not Cover
The following list of what Medicare does not cover includes many procedures or services that may be covered if medically necessary.
In those instances, we have denoted that the service is covered under specific circumstances.
For Medicare to cover that procedure or service, it must be determined to be medically necessary by your doctor.
Your doctor will then need to prescribe or fill out the proper documentation so that Medicare will provide coverage.
Be careful because even if the procedure is medically necessary without the doctor’s determination, you will be responsible for 100% of the cost.
The Ultimate List Of WHAT DOES MEDICARE NOT COVER:
- Adult Diapers
- Alternative Medicines
- Bariatric Surgery (coverage only for morbid obesity if medically necessary)
- Breast Augmentations
- Chiropractic Services (coverage only for manual manipulation of the spine if medically necessary)
- Chronic Care Services ( if you have two chronic conditions speak with SBS Agent)
- Concierge Care
- Contact Lenses
- Cosmetic Surgery
- Custodial Care
- Dental Implants
- Dental Services (a few exceptions for if you are in the hospital, Part A may cover)
- Electric Air Cleaners
- Eye Examinations
- Face Lifts
- Foot Care (routine)
- Fitness Programs
- Gym Memberships
- Hair Treatment
- Hearing Exams
- Hearing Aids
- Incontinence Pads
- Insulin (unless the use of an insulin pump is medically necessary)
- Long Term Care
- Massage Therapy
- Non-Prescription Drugs
- Nursing Home Care (unless you require skilled nursing care and it is medically necessary)
- Prescription Drugs Outpatient (usually coverage only includes drugs given in a doctor’s office)
- Shingles Shots
- Silver Sneakers
- Travel (there are a few exceptions that involve you being in the US, but a foreign hospital is closer or traveling between Alaska and the Continental US, and a Canadian hospital is closer)
There is an infinity of things that Medicare does not cover, such as, rubber ducks, power drills, and toupee’s, too.
But, a lot of these treatments, services, and prescriptions are covered with a Medicare Supplement.
OK, maybe not the ducks and drills.
Now that you armed with all of this new knowledge, maybe it is time to stop asking, ‘What does Medicare not cover?’ and ask, ‘Where can I get covered?’.
A great place to start is filling out our free no obligation quote below or calling a Senior Benefits Agent Today!