Learn What Medicare Covers
Generally, Medicare covers services (like lab tests, surgeries, and doctor visits) and items (like wheelchairs and walkers) it considers “medically necessary” to treat a disease or condition.
Factors that may affect what Medicare covers:
The law: There are federal laws that describe Medicare benefits, or state laws that tell what services a particular provider is licensed to give.
National coverage determinations: Medicare decides if a particular item or service is covered nationally.
Local coverage determinations: In each state, decisions are made by local companies that process Medicare claims. These companies decide if a particular item or service is medically necessary and should be covered in that area under Medicare’s rules.
Other coverage rules and policies may also apply. Medicare may cover some items and services only when you get them in certain settings, or if you have certain conditions. For example, some surgeries, like organ transplants, can only be done in certain approved hospitals.
Does Medicare Cover Wheelchairs & Scooters?
Medicare Part B covers power-operated vehicles (scooters) and manual wheelchairs as durable medical equipment (DME) that your doctor prescribes for use in your home.
You must have a face-to-face examination and a written prescription from a doctor or other treating provider before Medicare helps pay for a power wheelchair. Part B covers power wheelchairs only when they’re medically necessary.
Does Medicare Cover Hearing Aids?
Medicare does not cover hearing aids or exams for fitting hearing aids.
If you have a Medicare Advantage or Medicare Supplement Plan you may have coverage for hearing aids and exams. Check with your insurance agent to review your needs and coverage.
Does Medicare Cover Home Health Services?
Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medicare Insurance) covers eligible home health services like these:
Part-time or “intermittent” skilled nursing care
Physical therapy
Occupational therapy
Speech-language pathology services
Medical social services
Part-time or intermittent home health aide care (only if you’re also getting other skilled services like nursing and/or therapy at the same time)
Injectable osteoporosis drugs for women
Durable medical equipment
Medical supplies for use at home
Usually, a home health care agency coordinates the services your doctor orders for you. The home health agency caring for you must be Medicare-certified.
Medicare doesn’t pay for:
24-hour-a-day care at your home
Meals delivered to your home
Homemaker services (like shopping, cleaning, and laundry) that aren’t related to your care plan
Custodial or personal care that helps you with daily activities (like bathing, dressing, or using the bathroom), when this is the only care you need.
Does Medicare Cover Dental Services?
Currently, Medicare will pay for dental services that are an integral part either of a covered procedure (e.g., reconstruction of the jaw following accidental injury), or for extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw. Medicare will also make payment for oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances. Such examination would be covered under Part A if performed by a dentist on the hospital’s staff or under Part B if performed by a physician.
For more comprehensive dental coverage for preventative procedures such as cleanings and x-rays, fillings, dentures, etc. please talk to your insurance agent about options for coverage from a Medicare Advantage or Medicare Supplement Plan.
Where Can You Learn More About What Medicare Covers?
Visit Medicare.gov/coverage to see if your test, item or service is covered. You can also talk with your doctor or other health care provider about why you need the item or service, and they can help you understand if Medicare will cover it.
Bancorp Insurance Agency works with a variety of leading carriers in Oregon to provide you with the best options for Medicare Advantage and Medicare Supplement Plans. Bancorp’s insurance agents are available to provide you with a free review and consultation. Contact Us – Bancorp Insurance Call 800-452-6826
Disclaimer: This content is provided for general information purposes and is not intended to be used in place of consultation with our agents.
Sourced January 30, 2023 from Learning What Medicare Covers & Your Costs. Hearing Aid Coverage (medicare.gov), Wheelchair Insurance Coverage (medicare.gov), Home Health Services Coverage (medicare.gov), Medicare Dental Coverage | CMS
NOT AFFILIATED WITH OR ENDORSED BY THE GOVERNMENT OR FEDERAL MEDICARE PROGRAM.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.
Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call
1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
Please note that each insurer has sole financial responsibility for its products.
Not connected with or endorsed by the U.S Government or the federal Medicare program.
This is a solicitation of insurance A licensed insurance agent/producer may contact you.
