What Does Medicare Help Cover?

By CarePatrol

Medicare is a program the federal government uses for citizens 65 years and older (or disabled) to help them cover most of the costs of their medical needs. Here is some basic information about what Medicare will cover under Medicare Parts A and B — as well as hospitalization plus rehabilitation if needed.

• Ambulance services (ground or air in some cases)
• Artificial eyes, prosthetic limbs and any parts that need replacing
• Braces (arm, back, leg and neck)
• Chiropractic services to correct a subluxation
• Emergency room care
• Eyeglasses (one pair of standard frames after cataract surgery with an intraocular lens)
• Immunosuppressive drug therapy for patients with transplants paid for by Medicare
• Kidney dialysis
• Macular degeneration of the eye
• Not all nutrition, but medically needed therapy services for people with diabetes or kidney disease is probably covered
• Medical supplies (items such as casts, some diabetic supplies, ostomy bags, splints, and surgical dressings)
• Preventive services
• Prosthetic devices, including breast prosthesis after mastectomy
• Second opinion by a doctor (in some cases)
• In addition to doctors, nurse practitioners, physicians assistants, and clinical social workers are covered.
• Telemedicine services in some rural areas and a growing number of states
•  For people with diabetes, therapeutic shoes are usually covered
• Transplants (bone marrow, cornea, heart, intestine, kidney, liver, lung and pancreas under certain conditions and when performed at approved facilities)
• X rays, and other diagnostic tests if needed such as CAT scans, EKGs, and MRIs.
• Hospice and palliative care

Approximately 20% of these costs are not covered, so insurance companies offer coverage that has become known as “gap” policies to work with Medicare. Each year these policies are offered during open enrollment for current Medicare recipients, and all year long for those turning 65.

Medicare Health Plans known as Advantage Plans (like an HMO) may also include extra benefits such as dental care, exercise club membership, prescription drugs and routine physical and vision services.

These insurance companies provided plans to replace all of Medicare. What is not covered at all is what is referred to as custodial care. The government perceives family members will provide care in the home for meals, cleaning, assistance with activities of daily living, and transportation. If family members are not available, call us at CarePatrol for advice.