What does Medicare cover? All Medicare plans are required to cover certain benefits, including vaccines, annual wellness visits and medically necessary care. Some plans provide additional benefits. If you want any of the following 25 benefits, check your Medicare plan carefully because not all plans offer coverage.
- Glasses. Many older adults need glasses. Original Medicare doesn’t cover eyeglasses or contact lenses, but some Medicare Advantage plans do.
- Vision Exams. Original Medicare only covers vision exams that are needed to diagnose or treat medical conditions. Some Medicare Advantage plans provide additional coverage for vision exams.
- Dental Care. Good dental health is an important part of your overall health. Despite this, Original Medicare does not cover dental care, but some Medicare Advantage plans do.
- Hearing Aids. There’s been a growing push to add coverage for hearing aids to Original Medicare. However, for now, only some Medicare Advantage plans offer this benefit.
- Gym Membership. If you want a plan that will help you stay fit, consider choosing a Medicare Advantage plan that offers gym membership benefits.
- Home Fitness Perks. If you would rather exercise at home, some Medicare Advantage plans offer home fitness perks such as remote classes and fitness equipment.
- Transportation. Some Medicare Advantage plans offer transportation benefits to help enrollees get to their medical appointments. There may be limits regarding eligibility, distance, the number of rides available and more, so check your plan for details.
- Telehealth. Original Medicare has experimented with telehealth benefits. In addition to the telehealth benefits available under Original Medicare, some Medicare Advantage plans offer extra telehealth options.
- Home Healthcare. Original Medicare covers home health services such as medically necessary part-time or intermittent skilled nursing care or physical therapy when enrollees are considered homebound. Medicare Advantage plans provide similar coverage, but the rules may differ somewhat, and some plans may offer additional benefits.
- Adult Day Care. Some Medicare Advantage plans may provide coverage for adult day care, a benefit that Original Medicare does not provide.
- Housekeeping. After a hospital stay, you may need help with housekeeping. You may also need housekeeping to help manage asthma symptoms. Original Medicare does not provide this benefit, but some Medicare Advantage plans do if you meet the eligibility requirements.
- Home Delivered Meals. Some Medicare Advantage plans cover home-delivered meals in certain circumstances, for example, if you’ve recently returned home from a hospital stay. Check your plan for coverage and eligibility details.
- Acupuncture. Original Medicare only covers acupuncture to treat chronic low back pain, and only up to 12 treatments. Some Medicare Advantage plans may offer more robust acupuncture coverage.
- Groceries. Some Medicare Advantage plans offer a health foods benefit that provides enrollees with a limited amount of money to purchase healthy foods.
- Care in a Foreign Country. If you want to travel outside of the U.S., your Original Medicare coverage won’t follow you. Some Medicare Advantage and Medicare Supplement Insurance plans provide coverage for emergency care outside of the U.S.
- Caregiver Support. Both Original Medicare and Medicare Advantage can provide caregiver support under certain circumstances.
- Nonprescription Items. Some Medicare Advantage plans provide a limited allowance for over-the-counter items related to health, such as sunscreen or non-prescription medicine.
- Chronic Disease Management. If you have diabetes or another chronic condition, you might be able to find a plan that provides care management for it. Look for a Chronic Condition Special Needs Plan that serves your condition.
- Nutritional Counseling. Both Original Medicare and Medicare Advantage cover nutritional counseling under some circumstances, and some Medicare Advantage plans may have additional benefits.
- Chiropractic Care. Original Medicare covers manual manipulation of the spine when it’s necessary to treat vertebral subluxation. Some Medicare Advantage plans may offer more robust coverage for chiropractic care.
- Home Modifications. Original Medicare doesn’t typically cover home modifications, such as the installation of ramps or grab bars, but some Medicare Advantage plans may.
- Prescription Drug Coverage. Original Medicare does not provide prescription coverage, but Medicare Part D and most Medicare Advantage plans do.
- Prescription Delivery. Many prescription drug plans provide coverage for mail delivery of prescriptions. In addition to being convenient, this may be less expensive.
- Your Prescriptions. Coverage of individual prescriptions can vary from plan to plan. Make sure your prescriptions are covered.
- Your Doctor. Original Medicare doesn’t use networks, but some doctors may opt-out of the program. Medicare Advantage plans typically use networks, and if your doctor isn’t in it, your visit may not be covered.
Does your Medicare plan cover the benefits that matter to you? Consult with an agent.