Five Things You May Not Know Medicare Covers
Whether you’re new to Medicare, or you’ve been enrolled for years, you might not be aware of all the benefits available to you through your Medicare coverage.
Here’s a look at five important benefits that you should know about:
1. Telemedicine services
If you live in a rural area or you can’t leave home easily, Medicare provides telemedicine services so you can access medical care like psychotherapy, speech therapy, doctors’ visits, and others via audio or video communication with a medical professional.
If you’re enrolled in Original Medicare Part B (medical insurance), Part B pays 80 percent of the cost for most telemedicine service appointments with Medicare-affiliated physicians and health care providers. You pay the remaining 20 percent after meeting your annual Part B deductible.
The cost for a telemedicine visit is typically the same as an in-person doctor’s visit, but in some instances, you might have a different charge. For example, you may pay less if you have a Medigap plan, or you may pay more for different types of care.
2. Free vaccinations
As of January 1, 2023, Medicare covers more vaccines for free. Through its preventive care program, Original Medicare Part B covers 100 percent of the cost of the following types of vaccines:
- COVID-19 (If you have a Medicare Advantage (Part C) plan, you might have to pay a copayment if you go outside your plan’s network.)
- Influenza (seasonal flu)
- Hepatitis B (Medicare originally covered only those who were at high risk due to medical conditions)
- Pneumonia
As of 2023 when the U.S. Congress passed the Inflation Reduction Act, the following vaccinations are now free for Medicare enrollees:
- Hepatitis A for those who are at high risk
- Hepatitis B – now including people who are at low risk
- Respiratory syncytial virus (RSV)
- Shingles (two doses of Shingrix)
- Tdap (tetanus, diphtheria, and pertussis)
3. Free screenings for disease and medical conditions
Original Medicare Part B covers 100 percent of the cost for many preventive care services including screenings for the following medical conditions:
- HIV and AIDS
- Sexually transmitted diseases
- Diabetes
- Glaucoma
- Breast cancer
- Cervical cancer
- Colon cancer
- Prostate cancer
- Lung cancer
- Heart disease
- Depression
- Behavioral health issues
Medicare also covers 100 percent of the cost of tests for other conditions not listed above, so discuss your options with your health care provider.
4. Hearing exams
If you’re enrolled in Original Medicare Parts A and B, you’re probably aware that your coverage doesn’t include routine hearing exams or hearing aids. However, Medicare Part B might cover your hearing exam if your physician certifies that it’s medically necessary to diagnose or rule out an inner ear problem if you’re having problems with your balance.
If you have a Medicare Advantage (Part C) plan, your coverage might include extra benefits for routine hearing exams and hearing aids. Most Part C plans also include coverage for routine dental and vision care, so check with your provider if you aren’t sure what your Medicare Advantage plan covers.
5. Diabetes prevention programs
Medicare’s Diabetes Prevention Program (MDPP) provides coverage for 16 group sessions that include dietary coaching, lifestyle intervention, and physical activity programs for people who have been diagnosed as pre-diabetic. These prevention strategies help the beneficiaries make the necessary life changes to avoid diabetes. After the 16 core sessions, Medicare covers monthly follow-up group meetings to help enrollees maintain healthy behavior changes.
Medicare also covers obesity counseling for people with a Body Mass Index reading of 30 or higher. Because obesity can increase your risk for medical problems like diabetes and heart disease, Medicare covers this type of counseling under preventive care services.