Does Medicare pay for everything?

If you are nearing Medicare eligibility, it may be helpful to have an understanding of what Medicare does and does not cover before you settle on a plan.

What does Original Medicare cover?

Original Medicare (Part A and B), covers care you receive when you’re admitted to the hospital as an inpatient after an official doctor’s order, skilled nursing facility care, hospice care, home health care, and medically necessary services or health care used to prevent an illness or detect it at an early stage.

However, despite this vast amount of coverage, there are still services not covered under Original Medicare. These services include:

  • Long-term care
  • Cosmetic surgery
  • Hearing aids
  • Most dental care and dentures
  • Eye exams to prescribe glasses
  • Acupuncture
  • Foot care

What do Medicare Advantage Plans cover?

Medicare Advantage Plans, or Part C, must provide the same benefits offered by Original Medicare. However, Medicare Advantage can also offer additional benefits. If you’re concerned about not having coverage for the services Original Medicare does not cover, a Medicare Advantage Plan may be worth looking into.

Medicare Advantage covers:

  • Adult day-care services
  • Dental
  • Vision
  • Hearing
  • Fitness club memberships
  • Prescription drug coverage
  • Services and supports for those with chronic conditions
  • Transportation to doctor visits

Other coverage options

Medicare Supplements and Medicare Part D are other coverage options you can enroll in. Medicare Supplements can only be used with Original Medicare to cover the costs that Medicare does not cover. There are ten supplement plans you can choose from, all of which cover a portion of coinsurance, copayments, deductibles, excess charges, and foreign travel emergencies.

Medicare Part D covers prescription drugs, which can be bought as a standalone plan or through a Medicare Advantage Plan. You will need to view the plan’s formulary to ensure your prescriptions will be covered. 

Some of the drugs that Part D does not cover include:

  • Weight loss/gain drugs
  • Fertility drugs
  • Medications for sexual or erectile dysfunction
  • Cosmetic or hair growth drugs
  • Over the counter drugs

If you have any questions about your Medicare coverage options, give Temmen Insurance a call at 417-633-7200.

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