Over the past couple of months, I’ve been telling you about and explaining those things that Original Medicare does not cover. Thus far, I’ve talked about the most common health care issues people ask me about. The four things I’ve written about so far include dental, vision, hearing and Chiropractic care. It can be difficult to understand all the rules. Especially because with these, as in life, there are exceptions to the rules.
This week I have a couple of things on my mind. First, I will share a few more items Original Medicare does not cover. Second, and what is really on my mind, is an article I just read about the confusion beneficiaries have regarding Medicare Advantage (MA) plans.
A few more things Original Medicare doesn’t cover
There are ten things that Original Medicare (Parts A & B) does not cover. Here’s a quick look at a few more.
Elective Surgery
Elective cosmetic surgery is not covered. The key word to focus on here, is “elective.” Things like a tummy tuck or plastic surgery are not covered by Medicare Parts A or B. If my friend Jeff would like to have hair, this would be on his nickel. Medicare won’t pay for this. Ok, those are easy to understand.
Unlimited Physical Therapy
However, here is an example of something less obvious. Physical Therapy that is beyond Medicare’s limits. Medicare does not give an unlimited number of physical therapy visits. Different medical issues are assigned different allowable therapy visits. For example, a knee replacement won’t warrant as many therapy visits as a stroke patient.
Massage Therapy
Another item not covered, massage therapy. I have a nephew who suffers with chronic back pain and he always feels better after visiting a massage therapist. It helps him. So why doesn’t Medicare cover this? It’s because it doesn’t fix the problem, it is a temporary solution. Some Medicare Advantage plans offer coverage, but good luck finding a therapist in network.
Medicare Advantage Satisfaction Index Article
These health solutions are examples of things that confuse Medicare Advantage beneficiaries. Which is why a survey done by Retirement Living caught my eye. Their article was called Medicare Advantage Satisfaction Index.
This survey points out that 71% of Medicare Advantage beneficiaries are satisfied with their plan and 61% say it outperforms their previous plan. That’s good. Most of my clients in an MA plan like their plan. I have some positive video testimonies I hope to add to the website soon.
This survey added that only 44% of MA beneficiaries fully understand their plan, while 68% say certain details have caused confusion. Let me give you an example.
A client came to see me last week. She was confused about her dental benefits. She has had her MA plan for 5 years. Her dentist billed $3600 for dentures, and she thought her plan would pay for all of that. This year her plan gives her an annual benefit of $1000, which the plan paid. She was disappointed that her plan didn’t pay 100% of the cost of her dentures but was pleased to learn that they did pay their part. Prior to 2018 she was on Original Medicare and a supplement and that would have paid nothing towards her dentures. Let’s not forget that she is saving $250 a month in premiums.
The Takeaway
So, what is the takeaway from this blog? Too many people make their Medicare selection from a TV commercial or an alluring mailing piece. You’ll improve your position and walk away with a better understanding of your plan if you work with an experienced independent agent that understands the market you are in. Call us! We have over two decades of experience. You can also visit our website for educational elements. We can take the FUS out of the confusion.