“Is this covered?” It’s one of the most common questions I get from members wondering about seeing a new doctor, changing medicines or trying a new treatment option. And I’m glad they call and ask me. Knowing what appointments, tests, screenings and other services your Medicare plan coverage pays for is the first step to understanding how much you’ll have to pay for your health care.
What “covered” meansIf something is “covered,” it means your Medicare plan will help you pay for it. How much the plan pays depends on the type of care you use and where you get it. To get the most cost effective health care, you’ll want all the services you use to be covered by your Medicare plan.
Checking what’s covered Keep these areas in mind when checking coverage for each plan: DoctorsMedicare plans cover specific doctors, specialists and clinics, often referred to as a network. There are ways to find quality doctors who also offer the most coverage when you see them.
Medicines Plans have a list of medicines, called a formulary, which shows what medicines they cover. The list can give you a general idea of what you may pay for your medicines.
Different medicines are covered differently. For example, generic medicines are usually less expensive than brand-name medicines. So ask how much you’ll have to pay, and make sure it fits your budget. If it’s too expensive, your doctor can help you find a different drug, or the pharmacy might have a rewards or payment program. Services From doctor visits and physical therapy sessions to blood tests, X-rays, ambulance rides and hospital stays, Medicare plans cover health care services differently.
Healthcare exchange pa plans should only be considered by people who are in good health and who do not frequently use medical services. If you want to know more details please contact us.
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January 2020
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