Will Medicare Pay for That?
Greg Daugherty | Aug 1, 2017
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You are correct! You are incorrect!
Your lower back goes out of whack, and your doctor says acupuncture might provide some pain relief. How many visits will Medicare pay for?
Sorry, but Medicare doesn’t cover acupuncture treatments.
You stumble and sprain your ankle crossing a cobblestone street in Europe. Will Medicare pay your emergency room bill?
Medicare won’t cover you when you’re outside of the United States except in very rare instances. In addition to the 50 states and District of Columbia, its coverage area includes Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. A supplemental Medigap policy, if you’ve bought one, may cover emergency care in a foreign country as long as the care begins within 60 days of the start of your trip.
You think you may be experiencing heart attack symptoms and figure you’d better get to a hospital. Will Medicare pay for an ambulance?
Medicare will generally pay for an ambulance if you have a serious medical emergency and can’t get to the hospital by other means, such as a car or taxi. However, it will only pay the cost of transporting you to the “nearest appropriate medical facility.” If you want to go to a more distant hospital, any additional cost will be on you.
Your spouse suggests you need a hearing aid. (You think he or she mumbles a lot, but that’s not an argument we’re going to settle here.) How much of the bill will Medicare cover?
Medicare doesn’t pay for hearing aids. Nor does it cover routine hearing exams or the exams for fitting hearing aids. The only exception is if your health care provider orders hearing or balance tests in connection with other medical treatment.
Oh-oh, now you’ve broken a tooth. How much will Medicare pay to fix it?
Medicare doesn't cover most dental care or routine procedures. You can, however, buy separate dental insurance on the private market. If you’re enrolled in a Medicare Advantage plan (as opposed to original Medicare), you may also be able to add optional dental benefits to your coverage.
It’s been awhile since you’ve had a routine eye exam. How often will Medicare treat you to one?
Medicare generally doesn’t cover routine eye exams. However, you may be allowed a yearly exam if you have diabetic retinopathy or age-related macular degeneration or if you are at high risk for glaucoma. Medicare considers you at high risk if you “have diabetes, a family history of glaucoma, are African American and 50 or older, or are Hispanic American and 65 or older.”
If you’re a smoker, Medicare will help you kick the habit by:
To help smokers and other tobacco users quit, Medicare covers up to eight counseling sessions with a qualified doctor or other Medicare-recognized practitioner over a 12-month period.
You (or an older relative) are starting to have trouble with daily activities, such as bathing and getting dressed. You wonder if moving into a nursing home might make sense. Will Medicare help pay for it?
Medicare will pay for care in a skilled nursing facility but only if it is medically necessary. Patients who simply require “custodial” care, such as help with bathing or dressing, are not covered. However, the joint federal and state Medicaid program for low-income Americans may cover custodial care in a nursing home if you qualify. Another option is buying a long-term-care policy from a private insurer.
Flu season has arrived. Will Medicare pay for your annual shot?
Regardless of your age, Medicare normally covers one flu shot per customer every flu season. So get ready to roll up that sleeve.
You have both Medicare and retiree health coverage from a former employer. Which one should you send your bills to first?
In general, Medicare’s coverage will be primary, while your ex-employer’s plan will be secondary. After Medicare has paid its share, the employer plan may help you cover your out-of-pocket deductibles and coinsurance. It may also offer additional benefits beyond what Medicare provides. If you’re in this situation, Medicare suggests asking for a copy of the plan’s benefits booklet or summary plan description so you know what it covers.