Latest news with #PartB
Medical News Today
17-07-2025
- Health
- Medical News Today
Does Medicare cover an air ambulance?
Medicare may cover air ambulance transportation if a person has a medical emergency and needs to get to a hospital from somewhere a ground ambulance cannot reach. Air ambulances are usually helicopters or small airplanes. Medicare coverage for emergency flightsOriginal Medicare Part B may cover an airplane or helicopter ambulance if a person needs immediate and fast transport that ground transportation cannot Part B pays for 80% of eligible costs once a person pays their deductible, which is $257 in 2025. People are responsible for the remaining 20% of must also pay the Part B monthly premium of $185. This amount may be higher, depending on someone's a person has a Medicare Advantage plan, it is subject to the same rules as Original Advantage copayments, coinsurance, deductibles, and premiums can vary by the plan type, provider, and to the Centers for Medicare & Medicaid Services (CMS), the average 2025 Medicare Advantage premium is around $17 per month in addition to the Part B premium that a person must pay directly to much does an air ambulance cost with Medicare?Out-of-pocket costs for transportation via an air ambulance can be to the National Association of Insurance Commissioners, one 52-mile air ambulance flight can cost between $12,000 and $25,000. The high costs come from:initial aircraft costs (which can be up to $6 million)on-board medical equipmentmaintenance 24/7 availability for specially trained medical personnel and pilotsHelp with air ambulance costsPeople with Original Medicare can sign up for a Medicare supplement plan (also called Medigap) that may help pay for some of Part B's out-of-pocket costs. Medigap plans have monthly premiums, which vary by plan and can also consider registering with the Life Flight Network, a private air ambulance service that might help with remaining out-of-pocket costs.A basic Life Flight Network air ambulance membership costs $85 per and other ambulance servicesMedicare Part B commonly covers ground ambulances in emergencies, particularly when other transport options are unavailable or may harm a person's may sometimes cover nonemergency transportation if a doctor or healthcare professional deems it medically necessary.»Learn More:What transport options does Medicare cover?
Medical News Today
17-07-2025
- Health
- Medical News Today
Does Medicare cover Dexcom for glucose monitoring?
People with diabetes can use continuous glucose monitors (CGMs) to make tracking their blood sugar levels of drawing blood multiple times per day, a person continuously wears a sensor that sends frequent blood sugar readings to a smartphone app. Devices can also link to insulin pumps and separate covers diabetes care, and Part B should cover several types of CGMs for those with low blood sugar, also called hypoglycemia. Part B can cover Dexcom G7 or its earlier version, the Dexcom and Dexcom coverageTypically, Medicare Part B covers Food and Drug Administration (FDA)-approved CGMs, including the Dexcom Medicare Part B can cover Dexcom, as Medicare considers CGMs as durable medical equipment (DME).Medicare updated specific CGM eligibility rules in 2023 to make the devices more widely available. These rules now mean that a person can receive any type and amount of insulin or have a history of low blood must have an in-person or telehealth appointment with their doctor or healthcare professional within 6 months of ordering their no longer requires routine finger-prick blood sugar Medicare also requires a:prescription from a Medicare-approved physician or healthcare professionalperson's CGM training completiondoctor or healthcare professional who provided the prescription to monitor CGM use regularlyIf a person has a Medicare Advantage (Part C) plan, the same rules apply to them as those with Original Medicare (parts A and B).As private insurers administer Medicare Advantage plans, people can check with their plan provider to find out whether their coverage now includes the newest Dexcom version, the and Dexcom costsDiabetes Warehouse offers one Dexcom G7 sensor for $169.99. However, every supplier or pharmacy may charge 2025, after a person meets the Part B deductible of $257, the plan can typically pay 80% of CGM costs. People must also pay a Part B monthly premium, which begins at $185 and can increase based on their Medicare Advantage plans, a person's monthly premiums, deductibles, copayments, and coinsurance can vary by plan type, plan provider, and to the Centers for Medicare & Medicaid Services (CMS), the average monthly Medicare Advantage plan premium in 2025 is around $17. However, they must still pay the Part B premium to Medicare eligibilitySome people may qualify for a free or reduced-price Dexcom CGM through the manufacturer's patient assistance program (PAP). However, this is only available to those with type 1 diabetes and a specific income most people with type 1 or type 2 diabetes who have private health insurance, either personally or via an employer, could be eligible for the Dexcom G7 free trial.
Health Line
26-06-2025
- Health
- Health Line
Does Medicare Cover Foot Care?
Key takeaways Medicare covers foot care for injuries, emergencies, and treatment for certain conditions. In most cases, Medicare doesn't pay for routine foot care unrelated to a serious medical condition. People with diabetes can have routine foot care covered under Part B, including specialized shoes and shoe inserts. However, Medicare can cover routine foot care for people with diabetes if it's considered medically necessary. 'Foot care' can refer to treatment for serious conditions that affect the health of your feet or everyday concerns like calluses. Medicare separates these two kinds of foot care and only covers treatments that are medically necessary. In most cases, Medicare doesn't pay for routine foot care unrelated to a serious medical condition. However, you might have additional coverage for foot care if you have a Medicare Advantage plan. What kind of foot care does Medicare cover? Medicare covers foot care that's considered medically necessary. For care to be considered medically necessary, it needs to be prescribed by a physician or other licensed healthcare professional. Generally, Medicare will cover services you receive from a qualified podiatrist, although care from other physicians and healthcare professionals might also be covered in some cases. When you receive medically necessary foot care as an outpatient, it will be covered under Part B. Some examples of foot care that would be considered medically necessary include treatment of: wounds injuries infected nails hammer toe heel spurs If you receive foot care while you're admitted to the hospital, it will be covered under Part A. Just like with Part B coverage, the foot care you receive in the hospital must be considered medically necessary to be covered. No matter where you receive foot care, it must be performed by a Medicare-approved healthcare professional to qualify for coverage. Does Medicare Part C cover more foot care? Depending on your Part C, or Medicare Advantage, plan, you might have additional foot care coverage. Medicare Advantage plans are required to cover all of the same services as parts A and B. In many cases, Medicare Advantage plans offer additional coverage, which could include routine foot care. Check with your plan for specific coverage details before you go to your foot care appointment. What types of foot care are not covered? Medicare does not cover routine foot care, such as treatment for flat feet or fittings for orthopedic shoes. Routine foot care also includes hygiene and upkeep services, such as: nail trimming treatment of calluses removal of dead skin foot soaks application of lotions This applies to Medicare parts A and B, also known as Original Medicare. A Medicare Advantage plan might offer coverage for some of these services, including orthopedic shoes. What is covered for diabetes foot care? Some of Medicare's foot care rules are different if you have diabetes. Notably, people with diabetic peripheral neuropathy may receive a foot exam once every 6 months. Diabetes can lead to an increased risk of serious foot problems. Many issues are caused by nerve damage called neuropathy. Over time, this nerve damage can cause you to no longer feel any sensation in your feet. This can make it difficult to know if you've injured your foot or have a wound. People with diabetes are also susceptible to skin damage and ulcers, which can become infected. Additionally, diabetes can affect your circulation and reduce the blood flow to your ankles, feet, and toes. Together, all these factors can lead to serious infections that could eventually result in the need for a foot amputation. Medicare Part B covers foot care services for people with diabetes. These services include: nail care removal of calluses and corns specialized shoes and inserts You'll need a diagnosis of diabetic neuropathy to have these services covered by Medicare. If your podiatrist recommends it, you can be covered for one pair of custom-molded or extra-depth shoes each year, too, including the fitting appointments. Medicare will also pay for inserts to help your regular shoes provide the right support. If you prefer inserts instead of therapeutic shoes, you can get two pairs of custom-molded inserts or three pairs of extra-depth inserts each year. How do I qualify for these benefits, and what rules apply? To qualify for coverage, your condition needs to be under physician treatment. Your healthcare professional will need to show documentation that you're receiving treatment for a condition that requires foot care. For Medicare to begin paying, you'll need to be receiving active care for 6 months for that condition. Make sure you're enrolled in either Medicare Part B or a Medicare Advantage plan. Medicare Part A only covers hospital and long-term care expenses. Your podiatrist or other foot care professional must be enrolled in Medicare and accept assignment. If you're using a Medicare Advantage plan, you might need to use a healthcare professional who's in your plan's network. What costs should I expect? Your costs will depend on whether you have Original Medicare or a Medicare Advantage plan. Part B Under Original Medicare, you'll pay 20% of the Medicare-approved cost for services once you meet your deductible. In 2025, the Part B deductible is $257. Once you've met your deductible, Medicare will typically cover 80% of the cost of medically necessary foot care services and medical equipment, including diabetic footwear, if you meet certain conditions. You'll also need to pay the Part B premium. Most people will pay a premium of $185 per month in 2025. You can search for the Medicare-approved costs of foot care in your area on the Medicare website. Part C (Medicare Advantage) When you use a Medicare Advantage plan, the costs will vary depending on your plan's rules. You might have different coinsurance costs, a different deductible amount, or a different monthly premium. You might also need to stay in network to avoid higher costs. If your Advantage plan offers additional foot care coverage beyond Original Medicare, the costs will be outlined in your plan details. Medigap Medigap plans do not provide added benefits for foot care. However, Medigap plans might cover some of the coinsurance or other out-of-pocket costs leftover from your Part B coverage.
Health Line
16-06-2025
- Health
- Health Line
What Is the Medigap Open Enrollment Period?
The Medigap open enrollment period (OEP) is your first opportunity to enroll in a Medigap plan. During the Medigap OEP, you cannot be denied Medigap coverage due to a preexisting health condition. Medicare supplement insurance, or Medigap, is a type of private insurance that helps cover the out-of-pocket costs of Original Medicare. As with other parts of Medicare, Medigap has a set enrollment period for people new to Part B. In this article, we discuss the Medigap open enrollment period, its benefits, and what happens if you miss this window. When is the Medigap open enrollment period? The Medigap OEP is a one-time, 6-month window that begins on the first of the month you are enrolled in Part B and are age 65 years or older. If you sign up for Medigap during the Medigap OEP, you can join any plan in your state. Additionally, insurers cannot deny you coverage or charge you a higher rate due to a preexisting health condition. If you wait until after the Medigap OEP to join a plan, insurers are under no obligation to sell you a plan or charge you the standard rate. Insurers can evaluate factors like your medical history and age when deciding whether to sell you a plan. This process is known as medical underwriting. The Medicare website has a tool you can use to determine when and whether you're eligible to enroll in Medigap. Benefits of the Medigap open enrollment period If you're considering joining a Medigap plan, there are various benefits to doing so during the Medigap OEP instead of waiting. These include the following: You can join any plan in your state regardless of your health status. You'll have access to a wider array of plan options at lower costs. Your coverage will begin immediately (with the exception of expenses related to preexisting conditions, which are subject to a 6-month waiting period before the Medigap policy starts covering them). What happens if I miss the Medigap open enrollment period? As mentioned earlier, if you miss the Medigap OEP, you could be subject to medical underwriting when you try to enroll in a Medigap plan, resulting in fewer options and higher costs. However, there are situations where this may not apply, known as 'guaranteed issue rights.' These rights apply in certain cases where a person loses coverage or experiences a change in coverage. If you have guaranteed issue rights, an insurance company needs to sell you a Medigap policy, regardless of whether you have a preexisting condition, and they can't charge you more due to your health status. Some circumstances where guaranteed issue rights might come into play include: losing Medicare Advantage coverage due to: your plan leaving Medicare your plan leaving your area you moving out of the plan's area losing secondary insurance through an employer while enrolled in Original Medicare losing coverage due to the bankruptcy of your Medigap provider Some states have different Medigap rules. If you have questions about Medigap open enrollment in your specific state, consider reaching out to your local State Health Insurance Assistance Program (SHIP). Frequently asked questions How long is open enrollment for Medigap? Open enrollment for Medigap lasts 6 months. If you're age 65 years or older, the Medigap OEP begins on the first of the month that you have Part B coverage. Open enrollment for Medigap lasts 6 months. If you're age 65 years or older, the Medigap OEP begins on the first of the month that you have Part B coverage. Can I add a Medigap policy at any time? Yes, you can sign up for a Medigap policy at any time. Unlike Medicare Advantage plans, which require waiting for specific enrollment periods to join, switch, or drop coverage, you don't need to wait for a set enrollment period with Medigap. However, if you sign up for a Medigap plan outside of the Medigap OEP, insurance companies are free to deny you coverage or charge you a higher rate based on your health. Yes, you can sign up for a Medigap policy at any time. Unlike Medicare Advantage plans, which require waiting for specific enrollment periods to join, switch, or drop coverage, you don't need to wait for a set enrollment period with Medigap. However, if you sign up for a Medigap plan outside of the Medigap OEP, insurance companies are free to deny you coverage or charge you a higher rate based on your health. Summary The Medigap open enrollment period (OEP) is a 6-month window that starts at the beginning of the month when you're age 65 years or older and first have Part B. During the Medigap OEP, you can buy any Medigap plan offered in your state regardless of whether you have a preexisting health condition.
Health Line
09-06-2025
- Health
- Health Line
Will Medicare Pay for Contact Lenses?
In most circumstances, Original Medicare (parts A and B) doesn't pay for contact lenses. But some Medicare Advantage (Part C) plans may offer vision coverage. Original Medicare covers medical and hospital costs, but vision, dental, and hearing care aren't usually covered. This means you likely won't get financial help from Medicare to pay for your contact lenses. However, there are a few exceptions. For example, Medicare may cover the cost of contact lenses after cataract surgery. And some Medicare Advantage plans provide vision coverage. This article reviews how contact lenses might be covered under Medicare. Does Medicare cover contact lenses? While Medicare covers some vision services, it doesn't usually pay for eye exams or contact lenses. Some of the vision services that Original Medicare (parts A and B) may cover include: an annual glaucoma test for people at high risk (including those with diabetes or a family history of glaucoma) a yearly exam to test for diabetic retinopathy for those with diabetes cataract surgery diagnostic testing or screenings for macular degeneration Medicare Part B coverage Medicare Part B covers most outpatient medical services, such as doctor's visits, durable medical equipment, and preventive services. It doesn't usually cover contact lenses. However, there is one exception. If you have cataract surgery, Medicare Part B will cover one pair of corrective contact lenses after your surgery. When you have cataract surgery, your eye doctor will insert an intraocular lens, which can sometimes change your vision. As a result, you'll likely need new contact lenses or eyeglasses to correct your vision. Even if you wear glasses already, you'll most likely need a new prescription. It's important to know that Medicare will pay for new contact lenses after each cataract surgery with an intraocular lens insertion. Normally, eye doctors will only perform surgery on one eye at a time. If you have surgery to correct a second eye, you can get another contact lens prescription at that time. However, even in this situation, the contact lenses aren't totally free. You'll pay 20% of the Medicare-approved amount, and your Part B deductible applies. Also, you'll have to make sure you order contacts from a Medicare-approved supplier. If you usually order your contact lenses from a certain supplier, be sure to ask if they accept Medicare. If not, you may need to find a new supplier. Part C coverage Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare that combines Part A and Part B. To attract subscribers, Medicare Advantage plans offer some combination of dental, hearing, vision, and even fitness benefits. Medicare Advantage plans can vary greatly in the vision coverage they offer. According to health policy research nonprofit KFF, 97% of Medicare Advantage plans offer some level of vision coverage in 2025. Even with coverage, a person can still expect to have out-of-pocket costs. In 2018, Medicare Advantage enrollees who used their vision benefits spent an average of $194 on vision services. Examples of services Medicare Advantage plans may cover related to vision include: routine eye exams exams for fitting frames or contact lens prescriptions costs or copayments for contact lenses or eyeglasses Medicare Advantage plans are often region-specific because many involve using in-network providers. To search for available plans in your area, visit coverage finder tool. If you find a plan you're interested in, click on the 'Plan Details' button, and you'll see a list of benefits, including vision coverage. Often, you're required to purchase your contacts from an in-network provider to ensure the plan will cover them. Costs and other savings options The average cost of contact lenses can vary. Contacts range in features from daily disposable lenses to those that correct astigmatism, called toric lenses. In general: Daily disposable lenses are more expensive than monthly lenses. Multifocals are more expensive than distance-only or monovision lenses. Toric contacts for astigmatism are more expensive than spherical contacts. You'll also pay for accessories that help you care for your contacts. These can include contact lens cases, solutions, and eye drops — if you have dry eyes. It's a little harder to get help paying for contacts compared to eyeglasses when you have vision needs. Because glasses last longer than contacts and can be used and reused from donated materials, there are more organizations that may help you get a pair of free or low cost eyeglasses. However, you can save money on your contacts through these approaches: Order online: Many online contact lens retailers offer cost savings compared to ordering at a retail store. Just make sure you're using a reputable online source. You can also ask your retail store of choice if they'll match online prices. Purchase an annual supply: Although there's a hefty upfront cost, purchasing an annual supply of contacts often offers the lowest cost in the end. This is particularly true when ordering from online retailers. Look into whether company rebates could help you save. Look into Medicaid eligibility: Medicaid is a federal and state collaborative program that offers financial assistance for a number of medical costs, including vision and contact lenses. Eligibility is often income-based, and you can check your eligibility or learn how to apply on the Medicaid website. However, Medicaid may not cover contact lenses. Safety tip for wearing contact lenses When you do get your contacts, it's important that you use them as directed. Wearing them longer than recommended can increase your risk for eye infections, which can be both painful and costly to treat.
