Ineligible Charges – What Medicare does not cover
This is not a legal description – see actual law for specifics.
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- 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/
- Hospital observation does not qualify for Part A benefits – you want to be admitted.
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- Skilled Nursing Care if not hospitalized for 3 days, “observation” days do not qualify.
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- Some doctor wellness/physical testing can be beyond allowed schedule – ask before your physical.
- Annual wellness visits must be at least 365 days apart.
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- Doctors outside of the Medicare system (opt-out practices). Signed notification required.
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- Hearing aids and exams for fitting them.
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- Nursing home custodial care. (Short and Long Term Care policies can covers this area.)
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- More than 190 days of inpatient psychiatric hospital services during your lifetime.
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- Hospitalization after Lifetime Reserve of 60 days is exhausted.
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- Acupuncture
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- Routine (maintenance) foot care (including orthotics).
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- Chiropractic – except for adjustments.
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- Total cost for cataracts with enhanced lenses. Cataracts with standard lenses are covered.
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- Eye refraction even if part of cataract surgery.
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- Parts A & B need be in force for Medicare Supplement to pay benefits.
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- Dental is not covered – including accident coverage unless integral with other medical treatment – for accidents, look to homeowners, auto, or other insurances. Click here to see our dental plan offerings.
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- 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.