Medicare Shortcomings and Limitations 2019

//Medicare Shortcomings and Limitations 2019
Medicare Shortcomings and Limitations 20192018-10-15T11:19:38-05:00

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.
  • 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.
  • 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.