Ineligible Charges – What Medicare does not cover
Note: Beginning in 2019, annual limits have been removed on Occupational Therapy, Physical Therapy & Speech-Language Pathology (SLP) services.
This is not a legal description – see actual law for specifics.
- Hospital observation is not covered by Part A and prescriptions are limited.
Difficult if not impossible to change from observation to a covered admission status.
- 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.
- 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.
- Dental is not covered – including accident coverage – for accidents, look to homeowners, auto, or other insurances. Click here to see our dental plan offerings.
- 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.