Ineligible Charges – What Medicare does not cover

This is not a legal description – see actual law for specifics.

    • Hospital observation does not qualify for Part A benefits – you want to be admitted.
      • If you sign an observation authorization you will be paying the bill.
      • Ask a staff doctor (non-ER) or your personal physician to authorization your admission.

    • Dental – our self-service website page for DMO plans – http://www.deesigned.com/dental/
    • Skilled Nursing Care if not hospitalized for 3 days, “observation” days do not qualify.

    • Some doctor wellness testing – ask before your physical, ask that the bill be discounted.

    • Limited Part D vaccination shots* (Flu, Hepatitis B, Pneumococcal, Tdap (tetanus, diphtheria, pertussis))
      * Shingles vaccination not included.
    • Doctors outside of the Medicare system (opt-out practices). Signed notification required.
    • Hearing aids and exams for fitting them.  
    • Nursing home custodial care.  (Short and Long Term Care policies can covers this area.)
    • More than 190 days of inpatient psychiatric hospital services during your lifetime.
    • Hospitalization after Lifetime Reserve of 60 days is exhausted.
    • Acupuncture
    • Routine (maintenance) foot care (including orthotics).
    • Chiropractic – except for adjustments.
    • Total cost for cataracts with enhanced lenses. Cataracts with standard lenses are covered.
    • Eye refraction even if part of cataract surgery.
    • Parts A & B need be in force for Medicare Supplement to pay benefits.
    • COBRA – without Medicare A & B, no expenses eligible.
  • Administration of injections/infusions only covered in an outpatient setting – not in the home.



    Medicare Supplements help pay Medicare eligible charges – deductibles, co-insurances & copays.
    They do not add benefits to Medicare, with the exception of adding an additional year of hospitalization. Most Medicare Supplement plans also provide limited foreign travel emergency coverage.