How Do I Know What Medicare Covers? | A Guide to the Medicare “What’s Covered” App
What does my Medicare coverage include? How do I know what Medicare covers?
If you’ve found yourself asking these questions, you’re in the right place. Medicare can be a great coverage option, but it can only give as much as the consumer knows to use.
It’s vital to know exactly what services and providers your Medicare plan covers so that you can operate accordingly for your medical care. Fortunately, (like most things) there’s an app for that!
Read on to get an in-depth look at the Medicare “What’s Covered” app.
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How do I find out what Medicare covers?
From in-depth online research to calling up your doctor, there are a few different ways to figure out what Original Medicare covers. However, the easiest way will likely be to use the Medicare.gov “What’s Covered” app, where you can search specific services and find out whether or not you will have to pay for them entirely out-of-pocket.
As a general rule, Medicare Part A and Part B — or Original Medicare — have specific rules about what medical care they cover. However, specific tests, items and services are often dependent on personal factors like health and where you live.
Medicare Part A is hospital insurance, which covers inpatient care in a hospital, skilled nursing facility, hospice or hospice setting. Further, it may cover lab tests, surgery and home health care if they occur in an inpatient setting.
Medicare Part B is medical insurance, which covers doctors and other health care providers’ services during outpatient care. Part B also may cover durable medical equipment, home health care and specific preventive services.
How do I know what Medicare doesn’t cover?
When it comes to Medicare, there are a lot of extraneous factors that can influence whether a service is covered or not. Here is a general list of things that are not covered through Original Medicare:
- Long-term care
- Most dental care
- Most eye exams
- Cosmetic surgery
- Hearing aids and most hearing exams
- Routine foot care
However, depending on your health conditions, certain parts of the services listed above may be covered. Additionally, if you have a Medicare Advantage plan, you would be dealing with an entirely different set of coverage rules.
Keep in mind that Medicare Advantage is required to offer coverage for at least the same things as Original Medicare, though your costs will depend on your specific plan's deductible, copays, and coinsurance.
A Medicare Supplement fills in the gaps of Original Medicare coverage, covering costs like copayments, coinsurance, and deductibles. However, a Medigap plan does not add any coverage to services that are not already Medicare-approved.
Alternatively, a Medicare Advantage plan is very similar to the benefits of Medicare Part A and Part B but usually includes added benefits such as hearing, dental and vision care.
Regardless of what plan you have, one of the simplest ways to nail down your coverage is to use Medicare’s “What’s Covered” app to search services and get a straight answer in seconds.
How do I access the Medicare “What’s Covered” app?
If you search for “What’s Covered” or “Medicare,” you will be able to download the app with ease. Your screen will likely look something like this:
Once you install the app on your phone, you can get straight to the answers using the search bar at the top of your screen to input the item or service you are curious about. For example, if you are curious about whether Medicare covers the flu shot, you can find the brief answer in seconds.
Or long-term care? Not only will the “What’s Covered” app show you what is covered by Medicare, but it will also clearly indicate what is not covered.
Further, the app indicates the costs associated with each item or service, and certain health qualifications that may be required for coverage. “What’s Covered” is primarily useful for those who have Medicare with or without a Medicare Supplement plan.
If you have a Medicare Advantage plan, the app can still be helpful to know what your basic coverage entails. Since your coverage will be at least equivalent to Original Medicare, the app can be a handy tool to determine that level of coverage. However, it won’t highlight any of your extra Medicare Advantage benefits since a private company provides them.
Is the Medicare “What’s Covered” app easy to use?
According to most users, yes.
While the ease of any technology is an opinion, many seniors have found this app tremendously helpful in their Medicare journey. It's always nice to know where you stand, and the Medicare “What’s Covered” app can give you a clear, concise answer to your coverage-related questions.
If you’re interested in increasing your coverage or lowering your overall Medicare costs, give us a shout.
By giving us a call, you will be connected to one of our licensed agents. We can determine what areas of your Medicare plan could use some bulk and find the best possible plan for your needs.
*Disclaimer: Not endorsed by or affiliated with Medicare or any government program.
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