10 Medicare Part B Services Most Retirees Don’t Know Are Covered

Retirees know there are many services and medications that Medicare doesn't cover, although coverage can vary depending on the service, medication, and type of Medicare coverage. 

It could be hard to make sense of the confusing alphabet soup.

If you're budgeting for retirement, here's a quick, simple guide to what your Part B may pay for so you can plan accordingly, avoid paying out of pocket, and avoid making other surprising financial mistakes.

Eye exams

Forget what you've heard; Medicare covers certain types of eye exams.

However, it doesn't cover every type of eye exam. Medicare Part B does not cover "eye refractions" or exams to update your glasses or contact lens prescription. But Part B does cover certain eye exams, including annual glaucoma screenings for people at high risk and annual diabetic retinopathy exams for people with diabetes.

Eyeglasses or contact lenses, in some circumstances

Medicare Part B covers one pair of eyeglasses with standard frames or one set of contact lenses after each cataract surgery that implants an intraocular lens, although normal Part B cost-sharing applies.

While this sounds like a narrow rule, the procedure is more common than many think. According to the University of Florida College of Medicine, by age 80, over half of all Americans have cataracts, and nearly four million cataract surgeries are performed every year.

If you need vision correction unrelated to cataracts, you'll pay the full retail cost unless you have a Medicare Advantage plan or separate vision insurance that includes eyewear benefits.

Short-term nursing care

Most people know that Medicare does not cover long-term care like nursing homes and assisted living facilities.

Medicare Part A can cover short-term skilled nursing facility (SNF) care when eligibility requirements are met, including when a doctor certifies that you need daily skilled care. Covered services can include a semi-private room, meals, skilled nursing care, therapy, and other medically necessary services and supplies.

SNF coverage applies if you first have a "qualifying inpatient hospital stay" of at least three days in a row.

Time spent waiting in the ER doesn't count, even if you're there under observation overnight. Medicare starts counting from the day you were admitted as an inpatient and does not count the day of your discharge.

In some cases, you may not need the three-day inpatient stay if your provider participates in a qualifying Accountable Care Organization that offers a Skilled Nursing Facility 3-Day Rule Waiver. Medicare Advantage plans may also waive the three-day requirement.

Annual wellness visit

The standard "annual physical" that many people received before age 65 isn't covered under Medicare.

Instead, Part B covers a yearly Annual Wellness Visit at no cost if your provider accepts assignment, although you may owe costs for additional services performed during the visit.

Hearing tests

Medicare Part B doesn't cover hearing aids or exams for fitting hearing aids, but it does cover certain diagnostic hearing and balance exams when they're needed to determine whether medical treatment is necessary.

The cost of the hearing device falls squarely on your shoulders, though. Some seniors find solid deals at warehouse clubs like Sam's Club or Costco. Additionally, consider Medicare Advantage plans that cover more hearing-related needs.

Hearing issues are already expensive enough. Retail prices for hearing aids often run into the thousands, so make sure you are taking advantage of the limited auditory care that your Part B provides.

Cardiovascular disease screenings

This is a tricky one. Medicare Part B covers cardiovascular screening blood tests once every five years. You pay nothing for the screening if your doctor or other qualified health care provider accepts assignment.

Ask your provider whether they accept Medicare and assignment before scheduling the screening, since this can affect how much you pay.

Always check in advance to avoid an unexpected bill. Consider supplemental insurance that could cover the service, or schedule with a different provider in a participating clinic.

Foot care

Medicare Part B generally doesn't cover routine foot care, including trimming nails, removing corns or calluses, or other hygienic and preventive maintenance.

But Medicare does cover medically necessary treatment for certain foot injuries and diseases, including some foot problems related to diabetes.

Some chiropractor visits

Medicare actually covers some chiropractor visits, depending on the condition treated. While it won't cover other services or tests ordered by a chiropractor, such as X-rays, massage therapy, or acupuncture, Part B does cover manual manipulation of the spine to correct a subluxation.

Watch out for pricing, as these services are often bundled. Many retirees receive an unexpected bill from the chiropractor, assuming their visit was covered because it included spinal manipulation.

Select dental services

Medicare does not cover most dental services, but it does cover some. Original Medicare may cover certain dental services when they're closely related to specific covered medical treatments, such as certain cardiac procedures, organ transplants, cancer treatments, or treatment for end-stage renal disease.

For regular dental care, such as cleanings, fillings, and root canals, you must rely on Advantage plans with dental benefits or pay out of pocket.

Emergency transportation services, by land or air

Medicare Part B covers an ambulance ride or other ground transportation to the nearest appropriate medical facility if traveling in any other vehicle could endanger your health, and you need medically necessary services in a skilled nursing facility, hospital, or critical access hospital.

Your coverage even pays for emergency air transportation via airplane or helicopter if you need more rapid transport than ground options could provide.

These rules are important to know to avoid money mistakes. Medicare may cover certain medically necessary nonemergency ambulance trips, but it generally covers transportation only to the nearest appropriate medical facility that can provide the care you need.

Bottom line

Medicare Part B covers many essential services, but with caveats that could catch retirees off guard. Understanding what is and is not covered could help you plan more accurately for future health expenses and stretch your retirement dollars further.

Before you book care, call the provider's office to confirm their Medicare participation so you don't get stuck flat-footed with a hefty bill.

If you haven't done so yet, now's a good time to explore long-term care insurance and supplemental coverage options so you could compare plans and lock in the best rates.

You May Also Like

23 Ways To Get Money Without Getting A Second Job

By FinanceBuzz Editors

How To Save Money on Car Insurance: 12 Ways to Lower Rates

By Elyssa Kirkham

10 Things Seniors Born Between 1941-1969 Could Take Advantage Of

By FinanceBuzz Editors

19 Dumbest Things Smart People Waste Money On

By Team FBZ

7 Moves If You Want to Stop Living Paycheck to Paycheck

By FinanceBuzz Editors

7 Clever Ways to Crush Your Debt

By FinanceBuzz Editors

Save Money and Get Huge Discounts on Everyday Purchases

AARP Benefits

• Huge discounts on travel, groceries, prescriptions and more
• Access to financial planning resources and health tools
• Join AARP and get 25% off with automatic renewal

Become a member now!

---

Subscribe Today

Learn how to make an extra $200

Get vetted side hustles and proven ways to earn extra cash sent to your inbox.

or

Subscribe Now →

By submitting this form you agree to receive emails from FinanceBuzz and to the privacy policy and terms