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our Blog

What is Covered and Not Covered by Medicare?

12/29/2020

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Has the time come for you to apply for Medicare in New Jersey? You’ll be happy to know that Medicare is good insurance and the majority of people are happy with it. But, during a time with so much change, Medicare is just another thing to adjust to. And this can make it scary, especially when you’re not sure what healthcare services are covered and not covered. 

To help you understand your coverage options, you’ll need to know the different parts of Medicare: 

  • Part A provides basic hospitalization coverage.
 
  • Part B covers outpatient care like doctors’ visits and diagnostic testing.
 
  • Part C (Medicare Advantage) is a private option that combines Part A and B and offers additional benefits.
 
  • Part D is prescription drug coverage. 
 
  • Medicare supplement plans (Medigap) is private insurance that helps cover out-of-pocket costs like copays, coinsurance and deductibles. 

Medicare Part A 

Medicare Part A covers hospital costs when you are formally admitted with a doctor’s order. The insurance will pay for wheelchairs and walkers, hospice care, some home healthcare services, blood transfusions and limited coverage for skilled nursing. 

Medicare Part B

Medicare Part B covers doctor visits and preventive healthcare like yearly screenings and exams. Some of the tests and services covered are: 

  • Cancer and mental health screenings 
  • Ambulance and emergency department services 
  • Vaccinations for flu and hepatitis 
  • Medical equipment and diabetes supplies 

Medicare Part C 

Also called Medicare Advantage, this private option provides the benefits of Part A and Part B, as well as extra benefits like dental, hearing, vision and prescription drug coverage. You’ll pay a premium for this plan and only be allowed to see the doctors in your network. 

Medicare Part D 

Medicare Part D covers prescription drugs. This plan is optional, but we highly recommend it because you could face late enrollment penalties later on. 

What Doesn’t Medicare Cover? 

Medicare does cover a wide range of services, but there are some things it does not provide coverage for such as: 

  • Hearing aids 
  • Most dental care, including dentures 
  • Routine vision and foot care 
  • Long-term or custodial care 
  • Acupuncture  
  • Cosmetic surgeries 
  • Medical care overseas 

To ensure you have the coverage you need to be safe and healthy, it’s important to go over all of your options with a financial planner in NJ. Schedule a consultation with Leonard Financial Solutions to learn more about your coverage options and how to lower out-of-pocket expenses with a supplement plan. 

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