Medicare

Medical care must be deemed medically necessary in order to be covered by Medicare.

It is important for you to understand that Medicare does not cover everything and it does not pay the total cost for most services or supplies that are covered. You should talk to your doctor to be sure you are getting the services and supplies that best meet your health care needs.

The amount of your coverage is also dependent on whether you have coverage under Medicare Part A, Medicare Part B, or both.

Medicare Part A helps cover your inpatient care in hospitals, including critical access hospitals and skilled nursing facilities (not unskilled or long term care). It also covers hospice care and some home health care. You must meet certain conditions to get these benefits.

Medicare Part B helps cover physician services, outpatient hospital care and some other medical services that Medicare Part A doesn’t cover, such as some of the services of physical and occupational therapists and some home health care. Medicare Part B helps pay for these covered services and supplies when they are medically necessary. It also covers some preventive services.

A benefit is a health care service or supply that is paid for in part or full by Medicare.

If you belong to a Medicare+Choice plan, it must cover at least the same benefits covered under Medicare Part A and Part B. However, your costs may be different and you may have extra benefits, such as coverage for prescription drugs or extra days in the hospital. You should contact your Medicare+Choice plan administrator for specific coverage information for the plan in which you are enrolled.

Please consult your physician to determine whether the care you will receive is considered medically necessary.