Oak Creek Insurance Agency

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IN: What Medicare Covers

Dear Valued Customer,

In this issue of the “———————–” we focus on what Medicare covers.

What is Medicare Part A, and what is Medicare Part B, and what do they individually cover? What do drug plans cover? Learn which preventive and screening services Medicare covers to keep you healthy and find problems early, when treatment is most effective. How to get Medicare-provided medical care and prescription drugs in disaster or emergency areas. Read about how to replace a lost card, and lost or damaged equipment or supplies in disasters or emergencies.

We appreciate your continued business and look forward to serving you.

Kind regards,

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What Medicare Covers

Female Doctor with Stethoscope Holding Piggy Bank with Bruised Eye and Bandage.Find out if Medicare covers your test, item, or service.

What does Medicare Part A cover?

Read about what Medicare Part A (hospital insurance) covers, including inpatient care at a hospital, skilled nursing facility (SNF), and hospice. Part A also covers services like lab tests, surgery, doctor visits, and home health care.

What does Medicare Part B cover?

Learn about what Medicare Part B (medical insurance) covers, including doctor and other health care providers’ services, outpatient care, durable medical equipment, home health care, and some preventive services.

What drug plans cover

Learn what Medicare drug plans cover, including information about a drug formulary and tiers.

What Medicare health plans cover

Learn about Medicare health plans, which provide Part A and Part B benefits to people with Medicare. The plans include Medicare Advantage, Medicare Medical Savings Account (MSA), and Medicare Cost plans, and Demonstration/Pilot Programs, Programs of All-inclusive Care for the Elderly (PACE), and Medication Therapy Management (MTM) programs for complex health needs.

Preventive & screening services

Learn which preventive and screening services Medicare covers to keep you healthy and find problems early, when treatment is most effective.

Get medical care & prescription drugs in disaster or emergency areas

Learn how to get Medicare-provided medical care and prescription drugs in disaster or emergency areas. Read about how to replace a lost card, and lost or damaged equipment or supplies in disasters or emergencies.

Find suppliers of medical equipment & supplies

Get information about suppliers of durable medical equipment, prostheses and prosthetic devices, and orthotics.

Find & compare doctors, plans, hospitals, suppliers, & other providers

Find and compare hospitals, nursing homes, home health agencies, medical item suppliers, health care providers, health and drug plans, and dialysis facilities. Learn about how to choose providers and plans.

What’s not covered by Part A & Part B?

Learn about what items and services Medicare Part A and Part B doesn’t cover. You’ll have to pay for the items and services yourself unless you have other insurance or you’re in a Medicare health plan that covers them.

Source: Medicare.gov, “What Medicare covers.” http://www.medicare.gov. Accessed November 28, 2015. http://www.medicare.gov/what-medicare-covers/index.html

© Copyright 2016. All rights reserved. This content is strictly for informational purposes and although experts have prepared it, the reader should not substitute this information for professional insurance advice. If you have any questions, please consult your insurance professional before acting on any information presented. Read more.

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What Does Medicare Part A Cover?

Health-Wellness_ChemistWhat’s covered?

Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessaryto treat a disease or condition.

If you’re in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions.

In general, Part A covers: 

2 ways to find out if Medicare covers what you need

  1. Talk to your doctor or other health care provider about why you need certain services or supplies, and ask if Medicare will cover them. If you need something that’s usually covered and your provider thinks that Medicare won’t cover it in your situation, you’ll have to read and sign a notice saying that you may have to pay for the item, service, or supply.
  2. Find out if Medicare covers your item, service, or supply.

Medicare coverage is based on 3 main factors

  1. Federal and state laws.
  2. National coverage decisions made by Medicare about whether something is covered.
  3. Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

Source: Medicare.gov, “What does Medicare Part A cover?” http://www.medicare.gov. Accessed November 28, 2015. http://www.medicare.gov/what-medicare-covers/part-a/what-part-a-covers.html

© Copyright 2016. All rights reserved. This content is strictly for informational purposes and although experts have prepared it, the reader should not substitute this information for professional insurance advice. If you have any questions, please consult your insurance professional before acting on any information presented. Read more.

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What Does Medicare Part B Cover?

Health-Wellness_HandsomeDoctorWhat’s covered?

Part B covers 2 types of services

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Part B covers things like:

2 ways to find out if Medicare covers what you need

  1. Talk to your doctor or other health care provider about why you need certain services or supplies, and ask if Medicare will cover them. If you need something that’s usually covered and your provider thinks that Medicare won’t cover it in your situation, you’ll have to read and sign a notice saying that you may have to pay for the item, service, or supply.
  2. Find out if Medicare covers your item, service, or supply.

Medicare coverage is based on 3 main factors

  1. Federal and state laws.
  2. National coverage decisions made by Medicare about whether something is covered.
  3. Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

Source: Medicare.gov, “What does Medicare Part B cover?” http://www.medicare.gov. Accessed November 28, 2015. http://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html

© Copyright 2016. All rights reserved. This content is strictly for informational purposes and although experts have prepared it, the reader should not substitute this information for professional insurance advice. If you have any questions, please consult your insurance professional before acting on any information presented. Read more.