Is it Covered?  5 Things Often Underutilized in Medicare

The messaging is everywhere: The Medicare Open Enrollment Period (OEP) runs now through Dec 7.

The most important message for those already enrolled in Medicare, not said often enough, is: review your current plans and new options for 2022. Changes are made and new benefits become available every year. To obtain new benefits or save through a new plan, you must act during the OEP.

When reviewing your plan, be sure to explore newly available benefits. Many go underutilized. While concerns like medications, procedures, hospital stays and therapies are often front of mind, it is wise to think ahead about things like assisted living, medical equipment and in-home care.

 

Following are five things Medicare sometimes covers that often go underutilized.

1 Home Health Care

This benefit was created to provide the most cost-effective care outside of nursing homes and hospitals by providing support at home. People are sometimes surprised by what might be covered and with no copay — be sure to ask.

Some assume that because they haven’t been in the hospital, Medicare won’t cover their home care needs. While one must be deemed “homebound” and have a physician’s declaration that at-home care is required, a hospital stay isn’t needed to qualify.

2 Medical Equipment

Medicare Part B covers “durable medical equipment” for those who need help getting around. This can include walkers, wheelchairs, hospital beds, canes, crutches, oxygen tanks and equipment, blood glucose monitors and more. Typically, Medicare pays for 80% of the approved cost of these devices once the insured has met their Part B deductible. One piece of equipment few realize is typically covered (in part) by Medicare is a CPAP machine, which helps those diagnosed with obstructive sleep apnea breathe and sleep better.

3 Wellness Care Visits

As more older adults are taking better care of themselves, an increasing number need less healthcare. But that doesn’t mean they should forgo routine checkups. Preventive care is king, and Medicare covers free wellness doctor’s visits every 12 months. Seniors who smoke can take advantage of smoking cessation counseling, even without a diagnosis of a tobacco-related illness.

4 Chiropractic Care and Physical Therapy

Many seek chiropractic care to support their overall health and to relieve aches and pains. Chiropractic care is covered by Medicare Part B. Used to treat subluxations of the spine, chiropractic care can be covered without an x-ray to prove this condition.

Medicare covers many expenses related to physical, speech or occupational therapy. Yearly visits to these outpatient providers are limited, but typically a standard number is covered.

5 Prosthetics

Prosthetics can be costly. Artificial limbs and eyes are covered by Medicare when ordered by a doctor. Those who need external breast prostheses, such as implants and a post-surgical bra following a mastectomy, may find these are covered as well.

While Medicare may not cover every condition or need, when enrolling in or reviewing an existing plan, ask the experts. They are widely available, typically free of charge, and knowledgeable. As they keep pace with plan and benefit changes each year, they can help you obtain savings, and that one priceless thing: peace of mind.

 

Excerpts from medicare.gov