Medicare Supplement Insurance and Medicare Advantage Plans are two of the most common types of Insurance that we write for people, over the years we have helped thousands of individuals with their Medicare Insurance needs.
One question that we are frequently asked is if a procedure, surgery or test will be covered? – a good question to ask!
It is important to understand that Medicare makes the determinations as to what is covered and what is not.
Medicare Supplements pay most or all of the remaining balance of health care costs that Medicare does not pay on Medicare approved services – which includes the 20% coinsurance, the Medicare deductible and other co-pays that Medicare imposes. Again, your Medicare Supplement will only pay on Medicare approved services.
Medicare Advantage Plans also cover what is covered under Original Medicare and you will share in the cost of services that you receive. Sometimes Medicare Advantage Plans cover additional items that are not covered under Original Medicare such as vision coverage, but this additional coverage is usually very limited.
Medicare does a good job of covering most “medically necessary” items. When we are asked – “is ________ going to be covered by my insurance?” we usually respond by clarifying that, “if its covered under Medicare it will be covered by your insurance”. And again – Medicare’s scope of coverage is very good for “medically necessary” services.
It is a good practice to ask your provider, in advance, whether or not a suggested or prescribed service will be covered by Medicare.