1 in 5 Americans rely on Medicare for their health coverage. And millions might be missing out on these 10 hidden benefits to the program
A whopping 65 million people count on Medicare for their health insurance coverage, amounting to 20% of the population, according to the Kaiser Family Foundation.
And while the foundation points out that Medicare spending makes up 12% of the federal budget and 20% of national health care spending, many Americans aged 65 and older may still not be getting the most out of the government's health care program.
Medicare's basic, original Part A (hospital insurance) and Part B (medical insurance) cover obvious things you expect from health insurance: hospital stays, appointments with your doctor when you're sick, ambulance services, flu shots.
But it also also pays for many things that might surprise you.
If you're on Medicare or are approaching that time of your life, you'll want to be aware of these 10 Medicare benefits that enrollees often don't know about and that can keep you from dipping into your savings.
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1. Annual 'wellness visits'
Once you’ve had Medicare Part B coverage for a year, you’ll get what's called an annual wellness visit with your doctor, who will take routine measurements, such as your height, weight, blood pressure, and review your medical history.
You'll fill out a "Health Risk Assessment" questionnaire to identify risk factors — so you and your doctor can work on keeping you healthy.
Medicare says the appointments also can include "detection of any cognitive impairment." That means your physician will be on alert for signs of Alzheimer's or similar ailments.
2. Obesity counseling
Obesity causes many illnesses and can make frail older bodies much weaker.
Diabetes and heart disease rates skyrocket for those who are overweight or obese. Joint and bone diseases are easier to manage at healthy weight levels.
If you have a Body Mass Index (BMI) reading of 30 or more, Medicare will cover face-to-face counseling sessions in a primary care setting (like a doctor’s office) to help you bring your weight down to a healthier level.
3. Help to quit smoking
If you're a smoker, Medicare can help you kick the habit.
Letting go can be tough, especially if you've been a lifetime smoker. To help you break your nicotine addiction, Medicare will pay for eight in-person counseling sessions per year.
But note that Medicare's drug coverage will not pay for stop-smoking products sold over the counter at drugstores, like nicotine patches, lozenges and gum.
4. Some hearing exams
Basic Medicare usually won't pay for hearing aids or routine hearing tests.
But it may cover a hearing exam if your doctor says it's medically necessary.
Hearing is related to balance. When a senior is having balance issues, a physician may want to check the ears to see if there's an inner ear problem requiring medical treatment.
5. Hospice care
Hospice care comprises a host of treatments at the end of a person's life. Medicare will pay for a long list of hospice services, including nursing care, and grief and loss counseling for the patient and family.
Hospice coverage applies when a Medicare recipient has been given six months or less to live and has agreed to forgo further attempts at a cure.
Medicare-certified hospice care usually takes place where you already live — whether that be at home or in a nursing home. You can also receive hospice care in an inpatient facility. However, it’s important to note Medicare doesn’t cover your room and board, though it may pay for a short-term stay at a hospice facility if your hospice team determines you need that.
If you’re dealing with any other health issues not related to your terminal illness, that should also still be covered by Medicare. But the government’s Medicare site points out that’s fairly unusual. Once you select hospice care, the hospice benefit typically covers everything you need.
6. Counseling for alcohol problems
Much like smoking, alcohol abuse can have seriously negative effects on the wellness of an older person.
Medicare provides alcohol misuse screening and treatment free of charge. It covers one screening per year and up to four brief counseling sessions if the reviewing physician believes a patient needs help.
7. Disease screenings
Medicare covers screenings for numerous diseases as part of its preventive services.
Medicare will pay for testing to detect: HIV and other STDs; diabetes; glaucoma; breast and cervical cancer; colon and prostate cancer; and heart disease.
Patients with histories of smoking can get an annual lung cancer screening, and Medicare also covers annual screenings for depression and other behavioral health issues that are a concern for seniors.
8. Special footwear for diabetes
One of the least-known Medicare benefits is its allowance for specialized shoes for people with diabetes.
The disease can cause poor or abnormal circulation in the feet, and a lack of proper treatment can result in the need for amputation. Another risk is diabetic neuropathy, which can damage nerve endings in the feet.
Diabetic footwear helps regulate circulation and reduce the danger of neuropathy. Medicare will pay for one pair of custom-molded shoes and inserts and a pair of extra-depth shoes if they're prescribed and provided by a podiatrist or other qualified health professional.
Your insurance will also cover another two pairs of inserts for your custom-molded shoes and three pairs of inserts for extra-depth shoes each calendar year.
9. Wheelchairs and scooters
Wheelchairs and mobility scooters are important tools to help those with debilitating conditions lead normal lives. Medicare will pick up the cost under certain circumstances.
The wheelchair or scooter must be considered medically necessary.
Your doctor would need to certify that you are unable to walk without difficulty. The physician would be required to write a prescription for the vehicle or wheelchair after giving you an exam.
10. A walk-in bathtub (maybe)
A walk-in tub can help those with joint problems or other issues that make climbing into a traditional bathtub difficult or impossible.
Medicare may help with the cost of a walk-in tub, even though the tubs are not on the list of "durable medical equipment" that Medicare will cover including wheelchairs, oxygen equipment and hospital beds.
In order for you to obtain coverage, your doctor would have to attest that a walk-in tub is an absolute medical necessity. Medicare wouldn't provide assistance upfront — after you buy the tub, you'd submit the bill for possible reimbursement. But there’s no guarantee that you’ll get your money back.
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This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
