In addition to standard Medicare coverage, supplemental or Medigap plans are also available that cover specialist visits, prescriptions, and other medical services. The best Medigap plans vary in cost and the types of services that are covered and can be confusing when choosing the best one. The original plans are Medicare Parts A and B, which cover hospital and medical services respectively. Part A also covers nursing home care. Parts A and B can be combined, along with certain aspects of Part D into Medicare Advantage or Part C. Part D is the prescription drug program. There are also private supplement insurance policies that will cover some of the services that the four-part Medicare Plans do not. These four plans are offered by the U.S. Government and are available to all citizens that have paid into the Social Security system.
All Medicare recipients must receive pre-approval for any hospital stays and all care must take place at Medicare approved facilities. Health care providers are very well versed on the regulation of Medicare and what steps must be taken for their patients to receive coverage. Your separate healthcare supplemental plan would kick in after Medicare contributions are included.
Unsurprisingly, elective and cosmetic surgeries are not covered by Medicare. Dental care is not covered, nor are eye exams. Long-term care is not covered by Medicare but separate Medigap insurance policies can be purchased for that coverage.
There is no obligation to enroll in Medicare even if the account has been paid into. Private insurance is often used as a supplement to Medicare benefits in order to make sure that everything will be covered. A lot of insurance companies will pay on claims until all Medicare benefits have been exhausted.
The drugs covered and not covered by Medicare Part D is not set up with any hard and fast rules. There are also different levels of coverage, called tiers, that vary from medicine to medicine. Some of the best Medigap plans also include insurance benefits. It is best to consult a physician to review the drugs that are relevent and what their coverage status is.
Part A, the hospital stay coverage, carries no cost for people, and their spouses. who have paid into the Medicare system. If you do not qualify for free Part A the cost is up to $413 per month and coverage can begin at age 65. The cost for Part B is income based and can reach $134 per month. There are no Part B plans that are offered for free.
Durable and reusable medical equipment (often referred to as DMEs) are covered by Medicare, while one-time use items such as syringes are not covered. Additionally, the frequency allowed for certain services and supplies may be less than what is doctor recommended. Many private health insurance plans also cover these kinds of necessary medical supplies.
Following cataract surgery, Medicare will cover some corrective lenses, but in general, eyeglasses and eye exams are not covered by Medicare. In any instances where there are degenerative conditions or surgery is required, there may potentially be some coverage.
Many elderly patients receive regular care for various ailments such as blood pressure and diabetes. There can be certain limitations to the number of visits or medications that are covered during a specified period of time, such as a month or year. Meanwhile, healthcare supplement insurance plans often have some benefits with no caps, such as co-insurance and deductable coverage.