Medicare generally doesn't cover routine eye exams or eyeglasses (exceptions include an annual eye exam if you have diabetes or eyeglasses after undergoing certain types of cataract surgery). However, some Medicare Advantage plans provide eye coverage, or you may be able to purchase a separate supplemental policy that provides eye care. In addition, some Medicare Advantage plans cover emergency care abroad, including Home Care near Orefield PA. Or you can buy a travel insurance policy that covers some medical expenses while you're outside the U.S.UU. It can even cover an emergency medical evacuation, whose transportation aboard a medical plane or helicopter can cost tens of thousands of dollars.
Medicare parts A and B, or Original Medicare, provide extensive health coverage, but they don't cover everything. For example, Original Medicare generally doesn't cover long-term care, most dental care, eye exams to buy prescription eyeglasses, hearing aids, or cosmetic surgery. Medicare Part B generally doesn't cover routine eye, hearing and dental care, regular foot care, or devices such as eyeglasses, contact lenses and hearing aids. However, Part B policies change frequently, so it's important to verify coverage details with Medicare.
These are the most common medical expenses that aren't currently covered by Part B. For example, Medicare doesn't cover cosmetic breast augmentation, but reconstructive surgery after a mastectomy does. In all cases, if the patient's policy coverage is not clear, inform the patient that she may be responsible for paying for the service. For example, if you're hospitalized and need dental services to treat a condition, such as a fractured jaw, or if dental exams are required to prepare for certain surgeries, such as kidney transplant surgery or heart valve replacement, they may be covered by Medicare.
If you're eligible, Medicaid, which states administer according to federal guidelines, may cover nursing home care. Medicare generally doesn't cover health care services outside the United States, with some exceptions in case of an emergency. When Medicare or another payer designates a service as “combined”, it does not pay separately for parts of the combined service or allow the patient to bill it, since the payer believes that the payment is already included in the payment for another service which does cover. Medicare Part B (also known as health insurance) provides coverage for preventive and medically necessary care services.
The “exclusive” option eliminates the duplication of payment for these services, since you only pay once to provide the service. For example, orthopedic shoes that are part of a leg brace or therapeutic shoes for people with diabetes may be covered. Some examples are preoperative and postoperative care when a surgery is billed or the billing for several laboratory procedures when a single panel test represents the service provided. It also doesn't cover help for what are called “activities of daily living,” such as bathing, dressing, going to the bathroom, eating, or moving from one place to another in the house.
For example, all related services during surgery, from anesthesia to post-operative care, are included in a single payment. However, if you need treatment for a condition that's not related to the uncovered service, such as a broken leg during a hospital stay for cosmetic surgery, Medicare may cover treatment for the unrelated condition. Medicare provides coverage for some skilled nursing services, but not for custody care, such as help with bathing, dressing, and other nursing activities daily life. In addition, the Department of Health and Human Services finalized rules in April 2024 to review how Medicare Advantage customers obtain prior approval for care.
While not required, the ABN provides an opportunity to let the patient know that Medicare does not cover the service and that the patient will be responsible for paying for it.
