Medicare covers all services like surgeries, lab tests and doctor visits considered medically necessary for treating a disease or condition. Though you may have different rules with a Medicare Advantage plan or other Medicare plans, your plan should give you the same coverage offered by Original Medicare. There are some services that are covered only in some settings or for patients suffering from certain conditions.
Medicare Plan B covers two types of services viz. medically necessary services and preventive services. The medically necessary services are the supplies or services that follow accepted medical practice standards, and are required to diagnose or treat a medical problem.
Preventive services are the services used to prevent illnesses like the flu or detect them at an early stage when treatment works best. You don’t have to pay for most preventive services if you receive services from a health care provider who accepts assignments.
Medicare Plan B covers expenses like clinical research, durable medical equipment, ambulance services, a second opinion before a surgery, some outpatient prescription drugs and mental health on an outpatient, inpatient or partial hospitalization basis.
You have to talk to your doctor or other health care provider to discuss the reasons for your requiring some services or supplies and then find out if Medicare covers them. In case you need some service that is usually covered, but your provider thinks that Medicare will not cover it in your situation, it is important to read and sign a notice stating you agree to pay for the item, supply or service.
Medicare coverage is decided by three factors:
1. Medicare national coverage decisions about coverage of some things
2. Local coverage decisions made by the companies in the states that process Medicare claims these companies decide if a service or supply is medically necessary and should be covered in their region.
3. Federal and state laws
Cigna is a global health service company that concentrates on helping people improves their health, wellbeing and sense of security. The company offers an integrated suite of individual retiree pharmacy solutions, commercial group medical plans supplementing Medicare, Arizona Medicare Advantage HMO health plan and a wide range of commercial disability, pharmacy, dental and behavioral plans.
Humana is one of the nation’s largely traded health and supplemental benefits companies offering a wide range of health and supplemental benefit plans for government programs, employer groups and individuals including Medicare Plan B. Humana offers a comprehensive range of commercial and Medicare Advantage health, supplementary benefit and pharmacy plans for employer groups, individuals and government programs.