Medicare Part B covers the following services and items: Provider services: Medically necessary services you receive from a licensed health professional. Durable medical equipment (DME): This is equipment that serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home. Examples include walkers,
Archive for August, 2018
Summary of Part A-covered services
Medicare Part A covers the following services: Inpatient hospital care: This is care received after you are formally admitted into a hospital by a physician. You are covered for up to 90 days each benefit period in a general hospital, plus 60 lifetime reserve days. Medicare also covers up to
Vaccines and immunizations
Medicare Part D covers most vaccines and immunizations. However, there are certain vaccinations that are always covered by Part B: Influenza (flu) shots, including both the seasonal flu vaccine and the H1NI (swine flu) vaccine Pneumococcal (pneumonia) shots Hepatitis B shots Part B also covers vaccines after you have been
Accessing Part D coverage
Make sure to follow your Part D plan’s coverage rules when getting prescription drugs covered. This is the best way to avoid additional expenses and other issues. Before you go to the pharmacy, find out if your drug is on your plan’s formulary. If possible, ask your doctor to check
The Medicare Prescription Drug Coverage and Your Rights notice
When your Part D plan will not pay for your drug, you should receive a notice at the pharmacy titled Medicare Prescription Drug Coverage and Your Rights. This notice provides instructions on filing an exception request with your plan. Note that even though your plan will not pay for the
FEHB drug coverage and Part D
Federal Employee Health Benefits (FEHB) prescription drug coverage is creditable for Medicare-eligible retirees. This means that if you are enrolled in FEHB, you can delay Part D enrollment without incurring a late enrollment penalty (LEP). Be sure to compare the costs and benefits of your FEHB plan and Part D
TFL drug coverage and Part D
TRICARE for Life (TFL) offers a pharmacy program that provides creditable drug coverage. This means that if you are enrolled in the TFL pharmacy program, you can delay Part D enrollment without incurring a late enrollment penalty (LEP). Be sure to compare the costs and benefits of Part D and
Eligibility for DME coverage
Whether you have Original Medicare or a Medicare Advantage Plan, Medicare covers your durable medical equipment (DME) if you meet the following two conditions: Your primary care provider (PCP) must sign an order, prescription, or certificate after a face-to-face office visit. In this document, your PCP must state that the
DME costs when you are not affected by competitive bidding
The competitive bidding demonstration does not affect all states and regions. If you are not affected by competitive bidding, you will pay the least for your durable medical equipment (DME) when you use Medicare-approved suppliers who take assignment. That means they accept Medicare’s approved amount for health care services as
Renting and buying DME
Depending on the type of durable medical equipment (DME) you need, Medicare may require that you either rent or buy it. Most equipment is initially rented, including many manual and power wheelchairs. Original Medicare covers 80% of the cost of a monthly rental fee for 13 months. You pay a