Beneficiary Questions On What Medicare Parts A and B Do Not Cover

Because of the rise in the cost of Medicare premiums, customers should be aware of the services that are and are not covered by the various Medicare plans before selecting the Medicare strategy that is most suitable for them.

Hospital insurance is provided through Medicare Part A, which helps pay for inpatient stays in hospitals and skilled nursing facilities, surgery, hospice care, and some types of home health care.

The medical expenses associated with doctor visits, outpatient treatment, some preventative services, and some critical pieces of equipment are covered by Medicare Part B, which is a type of health insurance.

As a result, it is critical to investigate any coverage gaps before deciding whether or not to include Medicare Part C (Medicare Advantage), Medicare Part D (Prescription Drug Plan), or Medicare supplement insurance in the overall health care strategy of a Medicare beneficiary.

The Issue at Hand

It’s essential to consider what kinds of medical services are not paid for by Medicare.

The Answer

Original Medicare, which consists of Medicare Parts A and B, does not include coverage for the following medical procedures and services:

• Prescription drugs
• Long-term care services.
• Copays and deductibles.
• The use of hearing aids
• Routine vision care, including eyeglasses/contact lenses.
• Routine dental care, including dentures.

Original Medicare (Part A and Part B) does not cover most prescription medications. However, beneficiaries can address this coverage gap by enrolling in either Medicare Part D (Prescription Drug Plan) or Medicare Part C (Medicare Advantage) during the yearly open enrollment season, which runs from October 15 all the way through December 7.

When the Exceptions Aren’t Enough

In certain situations, Medicare Part B will pay for medications that can be taken outside the hospital.

The administration of medications covered by Medicare Part B usually takes place in an outpatient medical environment, such as a doctor’s office or a hospital clinic.

Examples of such medications include those injected for osteoporosis and those prescribed for use in conjunction with long-term medical devices.

The Dangers of Long-Term Care

Regarding out-of-pocket expenses, long-term care often accounts for the largest share.

The Original Medicare coverage does not extend to extended stays in nursing homes or assisted living facilities or stays in custodial care facilities.

Care that is highly specialized and received in a skilled nursing facility is covered under Medicare Part A for up to one hundred days throughout the beneficiary’s benefit term.

Medicare will pay for one’s treatment in full if they have been an inpatient at a hospital for at least three days and are admitted to a facility typically within the first 30 days following discharge.

It is essential to remember that Medicare Part C (Medicare Advantage) does not cover a significant portion of the costs associated with long-term care.

In this scenario, purchasing private long-term care insurance will be your best option.

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Bio:
After entering the financial services industry in 1994, it was a desire to guide people towards their financial independence that drove Aaron to start Steele Capital Management in 2013. Armed with an extensive background in financial planning and commercial banking coupled with a sincere passion for helping people, Aaron has the expertise and affinity for serving the unique needs of those in transition. Clients benefit from his objective financial solutions and education aligned solely with
helping them pursue the most comfortable financial life possible.

Born in Olympia, Washington, Aaron spent much of his childhood in Denver, Colorado. An area outside of Phoenix, Arizona, known as the East Valley, occupies a special place in Aaron’s heart. It is where he graduated from Arizona State University with a Bachelor of Science degree in Business Administration, started a family, and advanced his professional career.

Having now returned to his hometown of Olympia, and with the days of coaching his sons football and baseball teams behind him, he now has time to pursue his civic passions. Aaron is proud to serve on the Board of Regents Leadership for Thurston County as the Secretary and Treasurer for the Morningside area. His past affiliations include the West Olympia Rotary and has served on various committees for organizations throughout his community.

Aaron and his beautiful wife, Holly, a Registered Nurse, consider their greatest accomplishment having raised Thomas and Tate, their two intelligent and motivated sons. Their oldest son Tate is following in his father’s entrepreneurial footsteps and currently attends the Carson College of Business at Washington State University. Their beloved youngest son, Thomas, is a student at Olympia High School.

Focused on helping veterans and their families navigate the maze of long-term care solutions, Aaron specializes in customized strategies to avoid the financial crisis that care related expenses can create. Experience has shown him that many seniors are not prepared for the economic transition that takes place as they reach an advanced age.

With support from the American Academy of Benefit Planners – an organization with expertise and resources on the intricacies of government benefits – he helps clients close the gap between the cost of care and their income while protecting their assets from depletion.

Aaron can help you and your family to create, preserve and protect your legacy.

That’s making a difference.

Disclosure:
Investment advisory services are offered through BWM Advisory, LLC (BWM). BWM is registered as an Investment Advisor located in Scottsdale, Arizona, and only conducts business in states where it is properly licensed, notice has been filed, or is excluded from notice filing requirements. This information is not a complete analysis of the topic(s) discussed, is general in nature, and is not personalized investment advice. Nothing in this article is intended to be investment advice. There are risks involved with investing which may include (but are not limited to) market fluctuations and possible loss of principal value. Carefully consider the risks and possible consequences involved prior to making any investment decision. You should consult a professional tax or investment advisor regarding tax and investment implications before taking any investment actions or implementing any investment strategies.