What Medicare Doesn’t Cover
Many senior citizens are unaware of what is – and what is not – covered under Medicare. It’s wise to know, however, to avoid acquiring medical bills that may be difficult to pay on a fixed income. Increasing inflation costs make life increasingly difficult for all citizens but especially for senior citizens. Everything costs more – groceries, utilities, prescriptions, fuel, and medical care. Unexpected bills can equal financial diaster for seniors.
Medicare covers the cost of inpatient hospital care, skilled nursing care facilities, some types of home health care, and hospice care. Each type of care, however, has requirements that must be met to be eligible under Medicare. Nursing home care is covered only when an individual requires skilled nursing care. If someone requires nursing home care, ask about whether or not care will be covered under Medicare before making a commitment. Be sure to know the entire cost first.
More important, however, are the things that Medicare does not cover and these include:
Accupuncture. Although recognized by many cultures and individuals as a valid health treatment, it is not recognized by Medicare so keep this in mind before deciding on an acupuncture treatment.
Cosmetic surgery. Since cosmetic surgery is elective in the majority of cases, Medicare will not cover cosmetic surgery.
Custodial (non-skilled) care in a nursing faciity. Remember to ask first before committing to a nursing home facility to understand charges and levels of care.
Custodial home care. Some private insurance will pick up the tab for in-home care but Medicare will not so be aware before arranging for custodial home care.
most chiropractic care. Like acupuncture, many people swear that chiropractic care is beneficial but Medicare will not pay for this type of care.
Care outside the United States. Lower costs for many procedures in other nations often lures Americans to elect to have surgery, treatment, or care abroad. It’s always an option but it’s one that Medicare will not foot the bill on.
Dental care. No matter what type of dental care may be needed, Medicare won’t cover the costs so plan ahead for the financial costs of dental care.
Experimental procedures. If a procedure or treatment has not been proven, Medicare will not pick up the cost of any care termed experimental.
Eye exams and eyeglasses. Although many senior citizens wear eye glasses, Medicare will not cover the costs for any eye exams, eye glasses, or other corrective lenses.
Hearing aids. Sadly, seniors who have hearing issues won’t be able to purchase a hearing aid with help from Medicare.
Hospital telephones and/or televisions. Considered luxuries rather than necessities, Medicare won’t pay the bill for an in-room telephone or television so if one is desired, plan on paying the cost.
Private nursing care. Although the idea of a private nurse may have appeal and might even be necessary, the cost will not be covered by Medicare so budget first if private nursing care is anticipated or desired.
Most prescription drugs – to amounts covered by what new Medicare plan an individual has chosen. Consult individual Medicare plans for complete information.
Routine preventative care including physical exams, medical history, and preventative foot care. Unlike many other insurance plans, Medicare does not provide funding for routine prevention care.
Any hospital stay termed “outpatient” even if the patient spent one or more nights in a medical facility are not covered under Medicare. Since many procedures, even those that may require an overnight stay (or longer) are termed “outpatient”, it’s very important to ask before undergoing treatment to be sure that the current procedure is not termed “outpatient”. This can help avoid an unnecessary surprise when the bill arrives.
In most cases, allowed items will be paid after a deductible is met and patients are normally responsibile for 20% of all medical bills if they are utilizing Medicare. At today’s costs, even twenty percent of a bill can be a substantial amount so it may be wise to opt for additional coverage in addition to Medicare.
It’s best to ask about costs and coverage under Medicare before treatment is given so that senior citizens won’t have a bill that exceeds their ability to pay.
