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Plan 65

General Questions About Medicare

What does Medicare cover?
Medicare Part A (hospital insurance) helps cover:

  • Inpatient care in a hospital
  • Inpatient care in a skilled nursing facility (not custodial or long-term care)
  • Hospice care
  • Home health care
  • Inpatient care in a religious nonmedical health care institution

There are some limits on the number of hospital or skilled nursing facility days that Medicare helps pay for in a benefit period.

Medicare Part B helps cover:

  • Medically necessary doctor's services
  • Outpatient care
  • Home health services
  • Durable medical equipment
  • Some preventive services

To find out what the premiums may be for Medicare Part A and Part B, you can find that and more information in the Medicare & You Handbook or call Medicare at 1-800-633-4227.

Does Medicare have a deductible?
In 2018, Part A, the hospital part of Medicare, has a $1,340 deductible. Part B, the medical part of Medicare, has a $183 deductible.

Will I be covered by Medicare when I'm out of the country?
No, but some supplements do have limited foreign travel coverage.

Does Medicare cover durable medical equipment?
Medicare covers items such as oxygen equipment and supplies, wheelchairs, walkers, and hospital beds ordered by a doctor or other health care provider enrolled in Medicare for use in the home. For more information, please refer to the Medicare & You Handbook or call Medicare at 1-800-633-4227.

Does Medicare cover chiropractic care?
Medicare will pay for chiropractic care in some instances. For more information, please refer to the Medicare & You Handbook or call Medicare at 1-800-633-4227.

Do I have to be 65 or over to receive Medicare?
No, in some instances you can qualify for Medicare if you are disabled. For more information, please refer to the Medicare & You Handbook or call Medicare at 1-800-633-4227.

Does Medicare cover prescription drugs?
If you meet certain income and resource limits, you may qualify for extra help from Medicare to pay the costs of Medicare prescription drug coverage. For more information, please call Medicare at 1-800-633-4227 or visit medicare.gov.

Do I have to enroll in Medicare Parts A and B?
Generally yes. In some instances you can choose not to enroll in Part B. If you did not take Part B when you were first eligible, you may have to pay a penalty; in some cases, this penalty does not apply. For more information, please refer to the Medicare & You Handbook or call Medicare at 1-800-633-4227.

Does Medicare cover ambulance services?
If the use of an ambulance is medically necessary, the service is covered. Please refer to the Medicare & You Handbook or call Medicare at 1-800-633-4227.

What if I am a veteran?
If you are a veteran or a military retiree, you may be entitled to medical benefits. If you are a veteran, call the U.S. Department of Veteran Affairs at 1-800-827-1000 or visit their website at va.gov. If you are retired from the military, call the U.S. Department of Defense at 1-866-733-0404 or visit tricare.mil or tricare4u.com.

What is the difference between Medicare and Medicaid?
Medicare was designed to help with your medical costs as you age. Medicaid is a program for individuals who have a qualifying low income. Medicaid may pay some or all of your Medicare premiums and may also pay your Medicare deductibles and coinsurance. To find out if you qualify for Medicaid, please call Social Security at 1-800-772-1213.

What if my doctor doesn't work with Medicare?
A physician who does not accept assignment can charge up to 15 percent more than the Medicare approved amount. You must pay that extra amount. This is called the “limiting charge,” and you do not have to pay more than this amount. However, you will have to file all of your claims with Medicare yourself. You should contact your doctor if you are unsure if they participate with Medicare.

Will Medicare cover a yearly physical exam?
Yes, Medicare will cover a yearly "wellness" visit with certain restrictions. Please refer to the Medicare & You Handbook or call Medicare at 1-800-633-4227.

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