Does Medicare Cover What You Need? 3 Things to Know

If you rely on medicare to for your insurance it’s time to take a closer look and ask, “does medicare cover everything I need?” Here’s how to decide.

If you find yourself constantly entering the phrase “does Medicare cover…” into search engines, you aren’t alone. There are 47 million people aged 65 or older in the United States, and all of them have to learn the ins and outs of Medicare coverage.

When you first hit eligibility age, you find yourself asking a lot of questions about Medicare.

Will you have enough coverage for the medications you need? How will you be able to afford surgeries and procedures? Should you be expecting more or less coverage in the new year?

Luckily, we’re here to help you navigate the ever-changing landscape of Medicare coverage. If you have important questions about what Medicare can help you with, read on to learn more.

Does Medicare Cover What You Need?

In general, Medicare coverage should be able to help cover the basic medical needs of most senior citizens.

Medicare Parts A, B, C, and D are designed to give people the comprehensive health care they’ll need as they age. Aside from premium costs, you may not notice much of a difference between Medicare and old insurance plans.

If you have questions about Medicare or are concerned about getting proper treatment, it’s always a good idea to speak with your doctor.

A doctor can let you know about essential medications that you can’t go without, and could even recommend certain treatments or lifestyle changes that can help you thrive as you age.

What Three Things Does Medicare Cover?

Despite the occasional gaps in coverage, Medicare can cover a lot of common health care costs you receive.

We could write a series of posts about the differences between all of the different parts of Medicare. For now, we’re just going to focus on what you need to know: what you can expect Medicare to cover.

Doctors and Medicare providers can give you a list of certain medications and procedures that are covered by your plan, but we’re going to give you a general overview of the three most important things Medicare covers.

  1. Emergency Care

Emergency medical costs can be some of the most surprising and expensive debts you take on. Needed care for serious ailments and injuries won’t be cheap, but you will have care under Medicare.

Medicare coverage should handle any hospital visits and help from skilled or specialty nursing facilities. This could handle something as simple as an emergency room visit, or something more long-term like rehab.

If you need home health care after an injury or accident, Medicare should be able to help cover any short-term costs. In certain cases, Medicare can even help pay for a portion of hospice care.

It’s important to note that Medicare funds can go towards these services, but that they may not be able to cover the entire cost. It’s likely that you’ll still have to contribute some of your own funds to emergency care.

  1. Basic Healthcare

You won’t have to worry about being unable to see your doctor or to attend regular visits with other physicians. Preventative care and important regular visits will be covered under Medicare.

Preventative services like annual exams and flu shots will be covered under Medicare, as will medically necessary doctor visits.

If you go to the hospital for a procedure, your follow up visits should be covered under Medicare. Laboratory test and radiology needs like CT scans, MRIs, and x-rays will also be covered.

Mental health coverage under Medicare has significantly improved. You’ll be able to receive outpatient mental health care which can include visits to therapists.

Like with emergency services, you can receive help with any home health care you may need. This can include home-based physical therapy sessions or occasional check-ins from nurses.

  1. Prescription Drugs

Prescription drug coverage can get a little tricky under Medicare. Some drug manufacturers may have certain deals with Medicare providers, and others can lack them.

Medicare coverage may not extend to a certain drug manufacturer or kind of drug. But if there’s a certain medication you need that Medicare doesn’t cover, you still have other options.

Sometimes Medicare does cover certain medications, but only the generic form. Whenever you’re prescribed something by your doctor, be sure to ask if there’s a generic form of it you can take.

If there’s an expensive medication you need, you can also look into using a Medicare supplement to help you pay for it. Think of supplements as a form of gap coverage that can help you afford what you need.

What Doesn’t Medicare Cover?

Medicare can help you afford most medical costs, but not all of them.

Coverage can change over time, so it’s important to keep up to date on Medicare news. But in general, know that if you need any of these things, you should expect to pay out of pocket.

Hearing Aids

Medicare doesn’t cover routine hearing exams or hearing aids. Hearing aids can be expensive and cost a couple thousand dollars per ear, but Medicare recipients still have financial options available if they need hearing help.

Some discount programs provide lower-cost hearing aids. And if you go for a Medicare Advantage plan, some of your costs may be covered.

Routine Vision Care

If you have diabetes or have just had cataract surgery, Medicare will cover an annual eye exam to check on eye health. But that’s as far as most eye care coverage goes under Medicare.

In general, Medicare doesn’t cover routine eye exams or glasses. This is why many seniors choose to get supplemental coverage to set aside for eye exams, glasses, and contacts

(Most) Dental Care

Your Medicare plan won’t cover routine dental visits, teeth cleanings, fillings, dentures, and most tooth extractions.

If you have a Medicare Advantage plan, basic cleanings and x-rays may be covered but they have a low coverage cap.

Like with vision, many seniors choose to set aside money or get supplement coverage for dental work.

Your Turn

Now that you know the answer to all of your does Medicare cover questions, you’re feeling a little more conscious about your health. You want to do what you can to reduce care costs and live a healthier lifestyle.

If you want tips on living better, you’ve come to the right place. We have a lot of helpful content on this blog that can help you lead the best life possible.

Technology has made it easier than ever to stay healthy and in shape. Check out our guide on how to use smartphone apps to monitor health so you can start living better.

Image Credits: Medicare Cover from NicoElNino/Shutterstock

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