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Medicare Coverage

One question that is asked frequently when people are enrolled into Medicare is "What is covered by Medicare?" Perhaps a better question is "What's not covered by Medicare?"

Since Medicare's coverage is extensive and covers most hospital admissions, most out-patient physician-provided treatments, most laboratory testing and medically necessary supplies. However, there are some things that are not covered by Medicare.

Medicare does not cover routine dental or eye care. Medicare doesn't pay for long term custodial care. Medicare doesn't pay for dentures, hearing aids, acupuncture or cosmetic surgery. You should be aware that there are exceptions to this general guideline. For example, Medicare does pay for breast implants for women who've had a mastectomy due to a cancer diagnosis since this isn't considered cosmetic surgery. Medicare also pays for complex dental surgery that requires an individual to be admitted to the hospital. Medicare pays for treatment related to many eye diseases and routinely covers cataract surgery. In 2013, Medicare paid $6.8 billion for treatment of diseases of the eye.

Don't assume that Medicare does not cover a treatment you may need. If you have need for a specific treatment contact CHOICES (1-800-994-9422) to get the answer about coverage.