What Medicare Does and Doesn’t Cover

Updated on September 28, 2020

The reality is Medicare doesn’t cover you completely. You must know when you are covered and when you are not.

Luckily, we got you covered. The following breaks down what Medicare does and doesn’t cover, and what you need to get more coverage:

What Medicare Won’t Cover

Finding out that Medicare doesn’t cover everything surprises some people. While general treatment for infections, injuries, and illness is covered, that leaves a lot left out. With that said, you can get supplemental coverage when something isn’t covered by Medicare.

Cost of Health Tools

There are a lot of things that could help you maintain health, and sadly, some of these things won’t be covered, like medical equipment. Thankfully, you have a way to solve this problem. For example, you can look into Medicare Advantage plans, or plan C, to help cover the cost of medical equipment you might not get under regular Medicare plans. You’ll rest easy knowing that many Medicare Advantage plans will help cover the cost of scooters and other medical equipment, which is sometimes needed. You’ll also need to figure out how to cover hearing aids.

Major Gaps to Deal With

One issue to take care of is dental care. Medicare won’t cover dental health, so you are going to have to get supplemental insurance to take care of this part of your health. You might also want to get additional health care support for alternative health care options, such as acupuncture, if this is something you desire. It’s worth noting Medicare won’t cover things like cosmetic surgeries. Another significant gap you need to know about is long-term care or LTC, which is not covered either. You should purchase supplemental insurance just in case.

What Medicare Covers

An excellent way to know when you are covered and when you aren’t is to see if you’re an outpatient or not. Under plan A, you get covered only when you are an inpatient. When you are at the hospital, you need to know if you have this status. You can talk to your doctor to find out more information.

A Little More About an Outpatient

It’s kind of strange to imagine you can be considered an outpatient during a hospital visit, but these are the kinds of things you’ll have to keep in mind. To be an inpatient, the doctor has to admit you to the hospital officially, and that only happens under specific situations. You can be an outpatient and receive all sorts of services. You could have emergency services, lab tests, and even get x-rays without ever being fully admitted.

What is Covered as an Inpatient?

When you are an inpatient, you get coverage for all sorts of services, such as services from a nursing facility and home health care services. You get wheelchairs and coverage for the cost of blood if you need a transfusion. You get screenings for cancers, diabetes, and even depression. Each Medicare plan covers different things, so it’s important to read the fine print and find out which one works best for you. It may be a good idea to talk to an expert in Medicare planning to help you navigate the nuances of each plan.

These are just some things you should keep in mind when it comes to Medicare. Since a lot isn’t covered, you might want to talk to a financial advisor who can help you figure out your budget so that these additional costs don’t overwhelm you too much.

14556571 1295515490473217 259386398988773604 o

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.