Medical Service and Procedures Covered by Medicare

What Type of Medical Procedures Does Medicare Cover?

Medicare covers numerous types of medical services and procedures. Before they will cover it, however, you must have a documented and real reason for needing it. In other words, it just can't be something that would be nice to have. People in the hospital, home health care or nursing home will have their needs covered by Medicare Part A coverage. For people outside of those settings, Medicare Part B covers medical services and procedures. Samples of the types of medical services and procedures that are covered by Medicare include:

Ambulance Services
Approved Dental Surgery Related to a Covered Procedure
Approved Home Health Care
Cardiovascular Screening and Cardiac Rehabilitation Programs
Diabetes Screening
Diabetic Foot Exams
Emergency Room Visits
Mammogram Screening
Oxygen Therapy
Skilled Nursing Facility Care
Vaccinations

Many other services and procedures may be covered if they can be shown to be medically necessary and your doctor has documented it in your medical records.

Examples of items that are not covered by Medicare are:

What Do Services and Procedures Cost?

How much you will pay for medical services and procedures will depend on whether or not you have Medicare Part B coverage and from whom you receive your services and procedures. However, in general if you are enrolled in Medicare Part B:

And you have met your yearly deductible of $135 and do not have any secondary insurance, you will pay 20 percent of the approved Medicare amount.
And you receive Medicare through a Medicare Advantage Health Plan, you owe little to nothing depending on the plan that you are signed up with and the benefits of the plan. It is important to do your homework.

Read about the factors that affect how much coverage you will receive. Make sure all paperwork is completed correctly and that you receive your services and procedures through an approved doctor, healthcare provider, or supplier that accepts assignment.

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