3 Things You Never Knew About Medicare

March 28 01:00 2016 by ushadmin

If you’re getting close to age 65, or have even reached or surpassed it, you may be assuming that you know all you need to know about Medicare. If you mainly just know that it will provide health insurance for you in your golden years, you need to learn a little more. For example, there are different kinds of Medicare coverage to sign up for, some services and products are surprisingly not covered, and there is a bit of means-testing involved.

Selena Maranjian: One things that many Americans don’t realize about Medicare is that if they want Medicare coverage, they don’t have to sign up for the U.S. government-provided original Medicare coverage. Private insurance companies such as Blue Cross Blue Shield and UnitedHealth Group (NYSE: UNH) now offer Medicare Advantage plans.

Medicare Advantage plans, which debuted in 1995, are administered by private insurers but are regulated by the U.S. government. Each must offer at least as much coverage as what is now called “original Medicare” (i.e., the benefits you’ll find in Part A and Part B that respectively cover hospital and medical services). In order to attract customers, many offer broader coverage, such as vision and/or dental care. Most include prescription drug coverage, too. While original Medicare doesn’t cover healthcare provided outside the U.S., some Medicare Advantage plans do. While original Medicare will often have you footing 20% of many bills, a Medicare Advantage plan might charge you a low copay per doctor visit or service. Medicare Advantage plans also have out-of-pocket limits, beyond which the plan will pick up all your healthcare costs for the year.

Original Medicare lets you see any healthcare provider who accepts Medicare, but Medicare Advantage plans will typically limit you to a network of doctors — though these networks can be very big sometimes.

If you think you might be interested in a Medicare Advantage plan, see which ones are offered in your area. Know, too, that choosing between original Medicare and a Medicare Advantage plan isn’t a permanent decision. At least once a year, you will be able to switch between them.

One surprising fact about Medicare is that it doesn’t cover a lot of services that millions of elderly patients typically need. For example, Medicare generally won’t cover trips to the dentist, ophthalmologist, or audiologist, leaving recipients who want basic care for their mouth, eyes, or ears to foot the entire bill.

Let’s look at each in a bit more detail so you can know what to expect.

Medicare won’t pay for trips to the dentist for basic services such as cleanings, fillings, tooth extractions, or dentures. However, if have an extreme dental emergency and you wind up in the hospital, then Medicare will payfor certain dental services as part of your Part A benefit.

Just as with dental care, Medicare doesn’t pay for many eye care services, either. Need a routine eye exam, eyeglasses, or contact lenses? You will likely be on your own. There are a few exceptions to this rule, though, as Medicare will pay for an annual eye exam to check for diabetic retinopathy (if you have diabetes) and for a yearly glaucoma test (if you are deemed to be a high-risk candidate). It will also cover some tests and treatments if you have been diagnosed with age-related macular degeneration by an eye doctor. But that’s about it…