Medicare covers a lot. In fact, the vast majority of services offered by the various medical professions are covered. But it’s important to remember that there are new treatments, new medical devices, new drugs, and new remedies (we all know that apple cider vinegar and baking soda cure everything, right?) coming on the market all the time. Medicare does not cover these automatically.
In addition, Medicare does not pay every hospital for every service. For complex procedures like most heart surgeries and transplants, Medicare requires that hospitals be designated as “centers of excellence” based on their results in terms of survival, infections, complications, and so on.
Medicare regularly issues “coverage decisions” that specify what its management has decided to cover, or not. It also regularly enrolls and disenrolls providers for specific services. Recently, it disenrolled one of the nation’s major heart transplant centers because of poor results.
Medicare will cover any of the “ordinary and medically necessary” treatments, with some exceptions, unless they are required to be performed only in a “center of excellence.” If the services are not covered if performed in your hospital, you will be told and will usually be transferred. A list of centers of excellence for transplants can be found at Medicare-approved Transplant Programs.
If the services your doctor wants for you are not covered by Medicare, you will usually be informed. If you have a Medigap supplemental policy or a Medicare Advantage plan, it may cover the services Medicare does not. For detailed information on what each Medigap policy or Medicare Advantage policy covers, consult MedicareHaven.com.
The list is long, because the number of new treatments, drugs, etc., coming on the market is long. In general, the list includes:
In addition, some services, such as physical therapy, speech and language pathology, and rehabilitation have limits, and you must show satisfactory progress. The limits were increased for 2019, but still exist.
Medicare Advantage plans may cover some services and equipment that Original Medicare does not cover. For a list of what Original Medicare does cover, see Medicare Benefits 2019.
By the time you are eligible for Medicare, you may have a pretty good idea of the services you need. If, on the other hand, you have been blessed with excellent health, you may not have a clue. Your best bet is to contact one of the professional agents at MedicareHaven.com at 1-844-236-0228 to assess your needs and see which plan – supplement, Part D, or Medicare Advantage – is right for you.