Don’t Be Left Out!
When determining your optimal long-term healthcare coverage, it is essential to be fully aware of what is covered and, equally significant, what is NOT covered by your plans. This is particularly true when evaluating Medicare policies because your income may be decreasing while your healthcare needs are increasing. By understanding the overall Medicare exclusion guidelines, you can make the most informed coverage decision with your healthcare insurance adviser about enrolling in supplemental plans to fill in the gaps.
A few of the major items that are not included in Original Medicare (Part A and Part B) are routine eye, hearing and dental exams. Additionally, based on the medical condition there are established “reasonable and necessary” limits allowed for all costs and hospital stays.
Providers should give you a written Fee-For-Service Advance Beneficiary Medicare Notice before you receive items or services that are usually covered by Medicare but are not expected to be paid in specific instances. However, lack of notice does not guarantee coverage.
The critical takeaway is that whenever possible, minimize your out-of-pocket expenses by consulting with your healthcare providers, policy documents and subject matter experts about your needs prior to Medicare enrollment and before incurring medical expenses. Avoid stressful and costly surprises!
Review a more comprehensive list of Medicare exclusions.