• Call Us!  800-930-7006



Medicare Does Not Cover Everything.


Yes, Medicare insurance covers a lot.  It is one of the most comprehensive medical insurance plans in America.  It is also surprisingly affordable.  There is a wide range of benefits that are covered by Medicare.  And when contrasted that with Medicare fees, the value is unquestionable.  However, as great as the coverage may be, Medicare does not pay for everything.  There are several medical circumstances in which Medicare does not provide assistance.  If you are in the process of acquiring Medicare, knowing what Medicare does not cover, is essential.

What Medicare Does Cover.

So what does Medicare actually cover?  There are 4 parts to Medicare coverage: A, B, C, and D.  (Not to be confused with Medicare Supplement plan types - A through N).  Each Medicare part covers different segments of healthcare.

Most Medicare consumers enroll in part A and Part B.  These two parts together, provide coverage for a majority of medical circumstances.  And when part A and part B of Medicare is augmented by a Medicare supplement plan, the result is a complete, comprehensive, medical insurance plan.

Medicare Part A

Medicare Part A generally covers hospital services.  This coverage also includes many benefits that are naturally associated with hospital services, such as walkers or wheelchairs.  Comprehensive home healthcare services for a specific period of time, are also covered by Medicare Part A.  If you should ever need a blood transfusion, Part A also covers the cost of blood.

Note that unless your medical circumstance qualifies as an emergency, all covered medical services and benefits must be administered by a facility or entity that is part of your Medicare network.  Some medical services may also need to be approved by your doctor, or other qualified physician.

Medicare Part B

Medicare Part B generally covers physician services and more routine healthcare services.  For example, when medically approved, Medicare Part B coverage includes:

  • Preventative procedures, such as checkups, routine annual tests, screenings, and lab work.
  • Ambulance and emergency room services.
  • Electrocardiograms (ECGs).
  • Influenza, hepatitis and other vaccinations.
  • Some drugs, and some prescriptions for eyewear.
  • Medical equipment.

Medicare Part C

Medicare Part C plans, are also known as Medicare Advantage plans.  Medicare Part C plans are provided to the public by private insurance carriers that are specifically approved by Medicare to offer this type of coverage.  Medicare Advantage plans function very much like an HMO plan.  The Medicare program compensates insurance carriers that offer Medicare Advantage plans to consumers.  Consequently, as a subscriber, you are responsible for less costs.  In some cases, there can be little or no monthly premium associated with such plans.  However, benefits and services are far more "managed" with advantage plans.  In many cases, your medical choices - as far as who you can see and where you can go - are severely restricted.

Medicare Part D

Medicare Part D generally covers prescription drugs not covered by Part B.  While Part B typically covers drugs that are administered by a doctor, such as infusions or injections, Part D normally covers prescription drugs that you would pick up at a pharmacy.

What's not covered

Generally, medical circumstances that are not covered include:

  • Most dental care.
  • Eye exams that have nothing to do with a medical circumstance.
  • Hearing aids.
  • Acupuncture.
  • Cosmetic surgeries.
  • Chiropractor services.
  • Alternative medicines.
  • Weight loss medications and treatments.
  • Long-term care.
  • Other items that may not be listed here.

Questions? Give us a call.


Medicare Supplement Plan Comparison

Benefits Medicare Supplement Plans
  A B C D F* G K L M N
Medicare Part A Deductible No 100% 100% 100% 100% 100% 50% 75% 50% 100%
Medicare Part B Deductible No No 100% No 100% No No No No No
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Medicare Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%**
First three pints of blood 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part A hospice coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled Nursing Facility (SNF) coinsurance No No 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part B Excess Charges No No No No 100% 100% No No No No
Foreign Travel Emergency (Up to Plan Limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-Pocket Limit*** None None None None None None $5,240 $2,620 None None

*Plan F is also has a high-deductible option.  The F high deductible plan pays for all Medicare-covered expenses after you meet a $2240 annual deductible.
**Office copay exceptions: Some office visits may require a copayment of up to $20.  Emergency room visits may require a copayment of up to $50.
***Plan pays 100% of covered Medicare costs for the remainder of the calendar year once the out-of-Pocket limit is reached.

Call Us For HELP!   800-930-7006

More tips for purchasing Medicare Supplement coverage in Florida.
Medical Facilities in Fort Myers, Florida.