In order for a health care service to be covered by Medicare Part A or Part B, it must be deemed medically necessary.
“Medically necessary” is defined as health care services or supplies that are necessary to prevent, diagnose, or treat an illness, injury, condition, disease, or their symptoms within accepted standards of medicine.
In other words, medically necessary services consist of health care that is necessary to keep you healthy.
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Procedures, services, supplies, equipment and medications that are designed to treat the following are generally not considered medically necessary and therefore are not covered by Original Medicare:
Additional services that are not considered to be medically necessary include:
Medicare also includes a number of preventive health measures.
Although the following services and products may not seem medically necessary, they are covered by Medicare (certain restrictions are required for some services):
For more information about what Medicare does and does not cover, consult the Centers for Medicare & Medicaid Services’ Items and Services That Are Not Covered Under the Medicare Program.
Medicare Advantage plans cover everything Original Medicare covers, and some Medicare Advantage plans may also offer additional benefits such as prescription drug coverage, which Original Medicare doesn’t cover.
To learn more about Medicare Advantage plans where you live and the services they may cover – whether they are medically necessary or not – call today to speak with a licensed insurance agent.
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Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.