Medicare Questions & Answers: Coverage
Coverage Q&A
Showing 66 questions
Does Medicare cover eye exams, or are seniors left paying too much?
While Original Medicare (Parts A & B) doesn't cover routine eye exams for glasses or contact lenses, it does cover certain exams and treatments for medically necessary conditions like cataracts, glaucoma, and diabetic retinopathy. Medicare Advantage plans, which are an alternative to Original Medicare, often include vision coverage, including eye exams.
Is Medicare Part A enough for hospital coverage?
Part A covers hospital stays, but it is not always enough on its own. Most people need more than Part A.Consider Part B, covers Doctors, outpatient services and diagnostic testing.
Consider Medicare Supplement or Medicare Advantage, Part C.
Consider part D, prescription drugs.
Am I eligible for a Special Enrollment Period if I lose employer coverage?
Yes, you may be eligible for a Special Enrollment Period (SEP) if you lose your employer health coverage. This SEP typically lasts for 8 months following the loss of your coverage, allowing you to enroll in Medicare without facing penalties. It's important to inform Medicare of your loss of coverage to ensure a smooth enrollment process
Which Medicare Supplement plan (Medigap) offers the best value for most seniors, and why?
Plan G is usually the best value for most seniors. It covers almost everything except the Part B deductible, making it a solid choice for predictable costs and great coverage. It’s popular because it offers the most benefits without the high premiums of Plan F. (Which is only available for those eligible for Medicare before 1/1/2020) Plus, once the deductible is paid, there are no copays or surprise bills.
What does Medicare Part B cover? Is it enough?
After a $257 deductible (in 2025), part b covers 80% of most medically necessary services when using a doctor or facility that accepts medicare assignment. Some places may charge 15% more, but still accept Medicare patients. You or your supplement would be responsible for the excess charges.
What additional coverage options are available for international travelers?
Medicare Supplement plans (Medigap) C, D, F, G, M, and N may offer coverage for services outside of the U.S. with up to $50,000 of lifetime coverage. Some Medicare Advantage plans may also provide some coverage, and travelers should check with their specific plan for details. Additionally, international travel plans can provide emergency medical evacuation, return of mortal remains, support for lost passports or luggage, trip cancellation protection, and even kidnap and ransom coverage for high-risk destinations.
What’s an underrated benefit of Original Medicare that many people overlook?
The most underrated benefit of Original Medicare is freedom of choice. With Original Medicare you can see any provider as long as they take Medicare. no referrals are needed and it travels well. The coverage is Nation wide.Does Medicare cover health care services on a cruise ship?
Medicare may cover medically necessary health care services on a cruise ship if (1) the doctor is allowed under certain laws to provide Medicare services, (2) the ship is in a U.S. port or no more than six hours away from a U.S. port when services are provided. However, Medicare does not cover health care services when the ship is more than six hours away from a U.S. port.In what situations will Medicare pay for medical services in a foreign hospital?
Medicare covers services in a foreign hospital in three situations. First, if you have a medical emergency in the U.S. and the foreign hospital is closer than the nearest U.S. hospital that can treat you. Second, if you are traveling through Canada without unreasonable delay between Alaska and another state and a medical emergency occurs, and the Canadian hospital is closer than a U.S. hospital. Third, if you live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your condition, regardless of whether it is an emergency.
Is paying for a high-end Medicare Supplement plan really worth it, or is it overkill?
I believe buying the best Medicare Supplement plan available is the smart move. It costs more upfront, but the lower financial exposure and stronger benefits outweigh the savings from cheaper plans with weaker coverage. Most clients I’ve guided find the trade-off worth it when they need serious care. You’re not overpaying—you’re securing peace of mind.
What should I do if I find out that my preferred hospital isn't in-network with my Medicare Advantage plan?
You can go to any doctor or hospital with Medicare Advantage. Although, there have been instances where a hospital drops the Medicare Advantage plan. You can switch plans during Medicare Advantage open enrollment, Jan 1 to March 31. If you can't find another plan to switch to, you could return to Original Medicare and you could also pair Original Medicare with Medigap.
Does Medicare fully cover nursing home care, and are there alternatives?
In 2025, Medicare Part A is Limited to only 20 days of full Skilled Care and partial co-pay of up to 100 days total, per benefit period, when the senior leaves the inpatient 3-day minimum hospital admission stay. This is limited to Skilled Care Only. Not residential nursing home/long term care stay.Medicare provides zero Long Term Nursing Home Care funding. Per the 2025 Medicare and You Handbook, there are only TWO Nursing Home coverage options: Medicaid or private Long Term Care Insurance. Further, the Medicare Book recommends seniors plan for their long-term care NOW to ensure they can get the care they want, in the setting they want, in the future. Medicaid Spend Down laws can vary state by state and change each year.
Long Term Care Insurance policies written in 2025 and beyond can provide coverage at home, adult day care, assisted living, hospice, nursing home care, etc, without having to spend down ones assets and keep help control of their money and indepence.
I have multiple medications; how can I ensure my Medicare Part D plan covers them all without breaking the bank?
Medicare.gov you can log on and literally put in all your meds and then you can choose different plans and see what is/isn't covered!How can I get dental and vision coverage with Medicare?
In most cases, Original Medicare (in 2025) will provide very little or zero coverage for routine dental and vision costs. Most MA/MAPD plans offer some limited dental/vision coverage. Some dentist will recommend a senior purchase a stand alone dental insurance policy accepted by their dental practice. All dental coverage plans (private and MA/MAPD) will have plan limitations and some plans have waiting periods for some treatments/procedures.I’m on a supplemental Plan N, and I’m curious if my recent MRI is covered or if I’ll get stuck with a big bill.
With your Medicare Supplement Plan N, your recent MRI is covered under Medicare Part B as long as it’s deemed medically necessary, but you’ll need to meet the 2025 Part B deductible of $257 first, and then Plan N picks up the 20% coinsurance—though you might face a small copay, up to $20, if it’s done in a doctor’s office. Unlike Plan G, which also covers the Part B coinsurance but skips those copays and fully handles excess charges if a provider bills above Medicare’s rate, Plan N leaves you responsible for any excess, though that’s rare with MRIs since most imaging centers stick to Medicare-approved amounts. I’ve seen beneficiaries caught off guard by these details, so double-check your provider’s billing with your Explanation of Benefits to avoid surprises—either way, your bill should stay manageable compared to having no supplement at all.
I picked a Medicare Advantage plan last year, and I’m not sure if my hearing aids are covered. How do I figure this out?
You can find out that in the summary of benefits or evidence of coverage for your current insurance carrier.
If I need long-term care in the future, how does Medicare fit into that plan, and what should I be doing now to prepare?
This is a great question and I am pleased to hear that you are thinking about this proactively.Unfortunately, Medicare does not cover long-term care, such as your stay in a nursing/retirement home or having someone come to your own home daily for custodial care (bathing, dressing, feeding, ect.).
You should consider discussing a Long-Term Care policy with your agent/broker.
One thing to note is that as you age, these policies become more expensive. In many cases, people faced with the situation to enter Long-Term care may have to apply for Medicaid in order to receive any financial assistance or cover their costs. In some cases, extended family members may be able to contribute, however it can end up being a hefty financial burden.
Why might Original Medicare with a Part D plan be better than a Medicare Advantage plan for frequent travelers?
It really isn't since original Medicare only pays 80%, the member is responsible for 20% of everything which can become costly. and you have to PAY for Part D every month & pay for your medication. A Medicare Advantage Plan includes drug coverage with Tiers 1 & 2 usually $0 costs , depending g on the plan
What do seniors often misunderstand about Medicare’s coverage for long-term care?
Some seniors think that Original Medicare covers all aspects of post hospital care. That is not the case. Original Medicare only covers "Skilled Nursing Care" and only for a certain period of time. Occupational and speech therapy is post-hospital care most people need but is only covered under Long-Term and Short-Term care plans.
Is Medicare’s coverage for cataract surgery enough, or do seniors still face high out-of-pocket costs?
Original Medicare covers 80% of a variety of services including cataract surgery. Depending on how you subsidize original medicare your costs will vary. Medicare is a very individual choice and one to not take lightly. My job is to educate you on your choices to supplement and ensure you understand the pros and cons of each.What’s the deal with Medicare covering medical equipment like wheelchairs—do I need a special approval?
Medicare Part B covers durable medical equipment (DME) like wheelchairs when deemed medically necessary, but you must have a doctor’s prescription and obtain prior approval from Medicare to confirm it meets their criteria, such as being essential for use within your home. This includes items supplied by Medicare-approved DME providers, though many beneficiaries don’t realize this until a need arises, often prompting a last-minute call to advisors for clarification. Without proper approval, coverage won’t apply, and you’d face full costs, so verifying these requirements early is key.
How do I compare Part D plans to minimize costs for a mix of generic and specialty drugs?
Complete my survey including drug list and dosge. I can shop all drug plans by total cost(premium, deductible and copays)
I just started on Medicare Part D, and I’m confused about whether my new cholesterol medication counts toward my coverage gap. Can you explain?
Figuring out how your new cholesterol medication fits into Medicare Part D’s coverage gap can be confusing—it does count toward that limit, depending on your plan’s formulary and annual drug spending. In 2025, once your total costs hit the gap, you’ll reach catastrophic coverage after $2,000 out-of-pocket, lowering your costs to zero for covered meds, and Medicare now sends a statement detailing these expenses to keep you informed. Check that statement or your plan’s formulary for a clear snapshot of your progress!
I’m on Medigap Plan G, and I’m curious how my upcoming knee replacement surgery will be billed. Does the plan cover it all after my deductible?
Yes. After meeting your deductible your Medicare Supplement plan G would cover what Original Medicare doesn't cover
I just got Medicare Part A, and I’m worried about hospital stays. How do I know if my overnight stay will be covered fully?
Under Medicare Part A, you must first ensure that you have a doctor's order admitting you as an inpatient. This indicates that you require hospital care. Once you are admitted, Medicare Part A will cover the cost of your stay, including services like medication and testing, but it does not cover everything. That is where Medicare Part B steps in to cover the additional expenses of surgery. Of course, there will be more expenses that Medicare Part B will not cover, leaving gaps. That is when a Medigap policy comes in to cover all the remaining expenses.
I'm worried about the 'donut hole' in my Part D plan. How do I manage my medication costs once I enter it?
The Donut Hole was closed for 2025. No more huge out of pocket costs. The plans look completely different now. Please let me know if you would like more information. Happy to discuss how this was accomplished.What are some lesser-known benefits or services that my Medicare plan might cover that I could be missing out on?
This is a perfect question, and a great one especially in today’s time, as Medicare Advantage plans are introducing more creative and innovative benefits to differentiate themselves. You might find lesser-known Medicare Advantage perks like quarterly allowances for rent, utilities, groceries, over-the-counter items like pain relievers, or even transportation to medical appointments and gym memberships for wellness programs. Meanwhile, Medicare Supplement plans, such as G or N, often include a valuable international travel benefit for emergency care abroad, which can be crucial if you’re overseas and need treatment unexpectedly.I've had a change in my health condition. How does this affect my current Medicare plan, and should I reconsider my coverage?
on Medicare Advantage Plans there is NO underwriting, so regardless of the health of someone, everyone can get a Medicare Advantage Plan is long is their Part A & B are in effect. Medicare Supplements require medical under writing and based on results could require much higher monthly premiums
I picked a Medicare Advantage plan because of the dental and now I found out it only covers cleanings. Why didn’t anyone tell me this upfront?
I'm sorry to hear your expectations weren't met by your plan. The best way to prevent this issue is to look at the Summary of Benefits or the Evidence of Coverage. Your agent should have gone over this information with you. I recommend you get a new agent who will go over all benefits during sign up.Does Medicare Advantage cover acupuncture or alternative therapies in some plans?
That depends on what Medicare Advantage plan you have. Simply call the plan you have and inquire! Good luck!Can Medicare Part D deny coverage for a brand-name drug if a generic isn’t available?
Medicare Part D can’t deny coverage for a brand-name drug just because a generic isn’t available—plans must cover it if it’s on their formulary and medically necessary, based on your doctor’s prescription, though they might require prior authorization or step therapy to justify it over other options. Upon enrollment, I always encourage my clients to call me if their medication regimen changes during the year so we can verify coverage details with the carrier and avoid surprises. I’ve dealt with this plenty, and as long as the drug’s listed and no generic exists, your plan has to honor it under CMS rules, but check your formulary or call your provider to confirm it’s not excluded or restricted. If it’s off-formulary, you’d need an exception, which can be a hassle but doable with your doctor’s help.
How does Medicare Part B handle coverage for preventative screenings like mammograms?
Medicare Part B covers preventive screenings like mammograms as part of its focus on early detection and health maintenance, with specific rules on frequency, cost, and eligibility. Here’s how it works:Screening Mammograms: These are covered for women aged 40 and older to detect breast cancer early, before symptoms appear.
Frequency: Part B fully covers one screening mammogram every 12 months (anytime after 11 months from your last one). If you’re new to Medicare, you also get a baseline mammogram covered between ages 35–39.
Cost: There’s no out-of-pocket cost—no coinsurance, copayment, or Part B deductible—as long as the provider accepts Medicare assignment (agrees to Medicare’s payment rates). This applies to 2D and 3D (tomosynthesis) screenings, though 3D coverage was clarified in updates around 2018 to match evolving standards.
Diagnostic Mammograms: If a screening finds something abnormal or you have symptoms (like a lump), Part B covers diagnostic mammograms to investigate further.
Frequency: No strict limit—covered as medically necessary, which could mean multiple in a year if your doctor orders them.
Cost: After meeting the Part B deductible ($240 in 2025), you pay 20% of the Medicare-approved amount. There’s no cap on how many are covered, but each one triggers that 20% coinsurance unless you have a Medigap plan to offset it.
Key Details: The mammogram must be done at a Medicare-approved facility (like a radiology center or hospital outpatient department). If it’s bundled with other services (e.g., a biopsy), additional costs might apply under Part B’s standard rules. Preventive coverage assumes you’re symptom-free—once it’s diagnostic, it shifts to a treatment framework.
This setup reflects Part B’s broader approach to preventive care: full coverage for annual screenings to catch issues early, with cost-sharing kicking in when it’s about diagnosis or follow-up. It’s a balance between encouraging checkups and managing expenses when care escalates.
How do I know if a Medigap policy is right for me, and what's the best time to buy one?
This question cannot be answered without knowing all your circumstances, but there are just as many different answers to this question as there are agents in the field, as to why you should or should not. Again, a trustworthy agent can explain this in detail.
If Medicare Supplement (Medigap) plans are better for long-term coverage, why don’t more people choose them?
Advertising often misleads people to assume they know things they don't. The privatized companies that offer MA plans televise 9500 commercials per day! Have you seen many, if any, commercials regarding supplement plans? So many people don't have the information about them and the difference they make. In today's world, many seniors fear that they will be "Taken for a ride", so trusting a company or an agent is difficult.MA companies make it seem so easy! They lay out the positives, but don't show what is missing from the policies, such as the choice of practitioners, specialists, or travel benefits. It doesn't show that the highest quality choices very often do not accept the MA product. It doesn't show what Out-of-Pocket costs are if you do not choose a Network Provider. It doesn't clarify that in giving your Original Medicare back for the MA plan that you lose coverage for your Durable Medical Equipment needs. Those plans need to be changed every year, and the policy you have today may not be in place next year, or your Doctor may not even participate in that plan any longer. You rarely have that issue with Medigap plans.
And we cannot leave out that the premiums for the Medigap plans may be out of reach for some. Unfortunately, some find out too late that they chose "Easy" instead of "Thorough", and what they saved in premiums cost them hugely later on when they needed more quality coverage.
Does Medicare Advantage cover home health care?
Yes, if your doctor orders it. However, Medicare does not cover 24-hour-a-day care at your home, home meal delivery, homemaker services (like shopping and cleaning) unrelated to your care plan, or custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need. Some Medicare Advantage plans include some homemaker services when returning home from the hospital, so ask your broker.How well does Medicare support seniors who need assisted living, or does it fall short?
Medicare is health insurance and does not pay for assisted living. It is a good idea to get either a long-term care (LTC) plan or a hybrid life insurance plan with an LTC rider.Does Medicare cover hearing aids, or do I have to pay out of pocket?
No, some advantage plans do offer this coverage though in the form of free exams and copayments for the aids themselves. Costco and Sams also offer free exams and discounted aids.Is it true that Medicare pays for dental implants?
Who told you that? It does not! A few Medicare Advantage plans MAY have dental coverage that includes implants, but Original Medicare itself does not.
My mom is considering switching to a Medicare Advantage plan because her friends say it's better. She's scared of losing her current doctors. How can we check?
Her friends may endanger your mother. Medicare Advantage may have authorizations, Dr networks, service areas, referrals, Etc. It's easy for any Medicare broker to check her current doctors and see if they are in network for various Medicare Advantage plans.
I changed my plan during Open Enrollment and now I can’t see my regular specialist. Isn’t this what the whole review period is supposed to prevent?
The agent should have checked all of her doctors before they switched their policy. The client should of been aware of all of the benefits the new policy afforded her.
I thought I was covered during my snowbird months in Florida, but apparently not. What kind of plan do I actually need for that?
You actually have several options. Sounds like you have a HMO Advantage plan where you live. One option would be to stay on original Medicare with a supplemental plan. That would allow you access to any provider that accepts Medicare across the country. Another option would be a PPO Medicare Advantage plan if its available in you area. Several national carriers have network providers across the nation and would also provide coverage out of network.
I picked a PPO for the flexibility, but now every time I go out of network the bills are outrageous. What’s the point of even having a PPO?
Preferred Provider Organization, each Health Insurance company has a PPO Network and it is prudent to work within that Network if you can. PPO's are more costly for insurance companies because of the Out of Network usage. Try to work within your PPO Network to keep your costs down. Your Local Broker should be able to direct you to a copy of your Local Network of Providers. Your Insurance provider also has ways to search for In Network Physicians.
What’s the cheapest way to get Medicare coverage if I only need basic hospital care?
I would never advise someone to ONLY enroll in Part A (Hospital)If you skip Part B (outpatient care) to avoid its monthly premium - here’s the catch: if you delay Part B and later decide you need it, YOU'LL FACE A LATE ENROLLMENT PENALTY —10% added to the premium for each year you could’ve enrolled but didn’t—unless you have other creditable coverage (like an employer plan). Also, Part A alone won’t cover doctor visits, labs, or outpatient procedures, so if “basic hospital care” might stretch beyond inpatient stays, you’d be paying those extras fully out-of-pocket. For pure cost minimization with a hospital-only focus, Part A solo is your leanest option—just be sure your needs won’t creep into Part B territory later.
How does the Part D “catastrophic coverage” phase work once I hit the out-of-pocket max?
If you have met the "catastrophic coverage" phase, you will have no further responsibility towards drugs covered in your plan's formulary. However, if you are on medications not covered by your Part D prescription drug plan, you will still be responsible to pay those costs.If I start dialysis, how does that change my Medicare eligibility or coverage?
Most people on dialysys are covered on their plan. A member on Medicaid-Medicare, all cost would be covered, depending on their plan & cost share
What’s the likelihood of Medicare covering gene therapy as it becomes more common?
The likelihood that Medicare will cover something like gene therapy In my opinion is getting increasingly better. I’ve been in this field for about eight years and I’ve seen A lot of growth and adaptation from Medicare. I think in the near future Holistic medicine, naturopathy, gene therapy, Stem cell Based procedures will all have some kind of benefit that will be covered by Medicare.
I’m on Medicare Part B, and I’m wondering how my physical therapy visits are covered. Do I have to hit my deductible first?
If your on Medicare A and B only you would 20%. If your on a Medicare Advantage Plan, it usually has a copay that would be deductible for the MOOP.
I’ve been paying into Medicare for years, and I’m not sure why my specialist visits still cost me so much. What am I missing here?
That’s a great question, and one we hear a lot. Even though you’ve paid into Medicare through payroll taxes, that mainly covers Part A, which is hospital insurance—not everything. Part B, which covers outpatient care like specialist visits, has its own monthly premium and usually only covers 80% of the cost after you meet the deductible. That means you’re responsible for the remaining 20%, and there’s no out-of-pocket max unless you have additional coverage. This is where a Medicare Advantage or Supplement plan can help reduce or cap those costs. It’s frustrating, but you're not alone—Medicare can feel like a maze, and that's why it's worth reviewing your options to see what might lower your expenses moving forward.How do I appeal a decision by Medicare or my plan if they deny coverage for a procedure or medication I need?
Under traditional Medicare, you will appeal directly to Medicare, and Medicare supplemental/Medigap coverage must follow Medicare's lead in paying your coverage cost. With Medicare Advantage, you will deal directly with the insurance companies that write those plans.Should Medicare cover dental, vision, and hearing, or would that just make it more expensive for everyone?
I believe Medicare should have more dental, vision, hearing, and preventive care services built into the traditional system, just like many Medicare Advantage plans offer these services within their programs.Can Medicare pay for my groceries?
Medicare itself doesn’t pay for groceries—Original Medicare sticks to medical coverage and doesn’t touch stuff like food benefits. But I’ve noticed more Medicare Advantage plans stepping up with ancillary extras, like grocery allowances, built into many options now, especially for folks with specific health needs. It’s not universal, though—depends on the plan and if you qualify, so you’d need to check what’s offered where you are.
I'm caring for my dad who has Alzheimer's with lots of medications and I keep getting bills I don't understand. Any tips for not drowning in paperwork?
Depends upon the plan you have him enrolled in. Please reach out to me. I would be happy to walk you through the process. 918-210-3319.
I picked the plan with the lowest premium, but now every doctor visit feels like a surprise bill. Should I have gone with a higher premium instead?
If I knew what you have I could understand what you have.If you got a supplemental with a high deductible then you will be paying 20% of your bills until you hit 2700.
If you have a medicare advantage and it is no cost you should not have any surprise billing. It should only be the copay shown. I would have to look at your plan to understand what is happening
My plan covered my cataract surgery but not the lenses I actually needed—how do they get away with that?
Medicare typically covers the cost of the surgery itself, including the removal of the clouded lens and implantation of a a basic intraocular lens (IOL) only. If you or your doctor believes that a specialty lens is a medical necessity, you may file an appeal with Medicare (if you have original Medicare) or your Medicare Advantage plan (if you are on an MAPD).
I called to ask about a knee replacement and suddenly they said I need prior authorization. I thought my plan was supposed to be good—what’s going on?
If you have a Medicare Advantage plan thy could ask for a prior authorization. It also could depend on the healthcare provider, or weather it is an HMO or a PPO.
Why do doctors not like Medicare Advantage plans?
Medicare Advantage plans are managed care plans. This means that the insurance companies have the ability to require different things to receive care like preauthorizations, step therapies, and limitations on certain types of procedures.My friend lives in a different city and has a much more detailed Medicare plan. Is their location dependent on their plan?
Yes. You must enroll in a plan available in the service area that matches your legal address. My friends and family members give advice to and mention specific plan benefits. Plan specifics differ across the country. If there is a benefit that you are interested in, please ask. If you don't mention something, your advisor may never know that it was important to you. We ask as many questions as we can to start a conversation, to determine what is most important for each potential client.
Does Medicare cover emergency care if I’m traveling in a U.S. territory like Puerto Rico?
Yes(Si), you have coverage anywhere in the US and its territiories with Medicare and Medicare Plans, including Puerto Rico.
Are home modifications (like stairlifts) ever covered by Medicare for safety reasons?
Hello, usually modifications such as this are not covered, but you should check your plan for details.How can I estimate my total Medicare costs if I have a chronic condition like diabetes?
Estimating your total Medicare costs will depend on how many doctor visits you have and the cost of any diabetic medicine you take which can be outlined in your Part D drug plan. I can provide you with a PDF outline of your costs.What should I do with my Medicare plan if I’m diagnosed with a rare disease requiring specialists?
Great question.if that rare disease is going to lead to expensive complications down the road, it may be a good idea to look into a supplement plan like a “G” or “N”. The tough part would be passing underwriting since you’ve recently been diagnosed. If you’re unable to pass underwriting Then you may just try to get familiar with your advantage plan costs and if possible, get familiar with all of your lesser expensive “in-network” options. It may be a good idea to utilize your broker or contact the Member Services number for your insurance and get a list of providers in your area.How does losing a spouse impact my Medicare plan if I was on their employer coverage?
When a client loses a spouse and was on their employer coverage, I explain they have 63 days to enroll in Medicare or adjust their plan without facing a penalty. It’s a qualifying event, so they’d need to switch to their own Part B if they’re 65, and I’d urge them to do it promptly to avoid any cost hikes or coverage lapses. The rules give them a clear path forward, but timing is critical.How might climate change-related health issues (like heat stroke) influence Medicare policies?
In my 25 years working with Medicare, climate change-related health issues like heat stroke have never come up in discussions or policy updates—not once. Honestly, it’s not something I’ve ever thought about either, but I’d assume it wouldn’t shift Medicare coverage much since conditions tied to it are already baked into what’s covered. Any impact would likely stay minor, handled within existing frameworks.
I’m on Original Medicare with no supplement, and I’m wondering how much I’d pay if I need an ambulance ride to the hospital tomorrow.
Original Medicare generally covers ambulance services when they are medically necessary. This means that transportation in any other vehicle could endanger your health. This coverage applies to both emergency and certain non-emergency situations.Your Potential Costs:
- If Medicare covers your ambulance trip, you'll typically be responsible for 20% of the Medicare-approved amount.
- You'll also need to meet your Part B deductible for the year before Medicare begins to pay its share.
The actual cost of an ambulance ride can vary significantly depending on factors such as:
- The distance traveled.
- The level of care provided during transport (e.g., basic life support vs. advanced life support).
- Your location.
I’ve got Medigap Plan C, and I’m curious if my recent bloodwork is included or if I need to budget for extra costs.
The bloodwork is included in your Medigap plan C under the Part B benefits.The plan C covers 100% of your Part B coinsurance or copayment.