Surprising Medicare Benefits
I have been working with Medicare for over 16 years; I get calls all the time from beneficiaries asking if Medicare covers certain procedures or services. The key words with Medicare is “Medically Necessary” and “Maybe”. Those are very frustrating words when you are facing medical expenses. If something is medically necessary to treat a disease or condition then Medicare will probably cover that treatment.
Some things that Medicare covers may be a surprise to many people. One benefit is obesity screening and behavioral counseling to help you lose weight; approximately 35% of seniors over 65 are obese. Obesity puts seniors at risk of chronic diseases such as type 2 diabetes, heart disease and high blood pressure among other illnesses. If a beneficiary has a body mass index of 30 or more Medicare Part B will cover the screening and behavioral therapy to help lose weight by changing their diet and exercise.
Medicare also has a tobacco cessation benefit for those who use tobacco products and wish to stop. By now, everyone knows that tobacco use can cause many health issues, but quitting tobacco use is very difficult. Medicare Part B can cover up to eight in-person smoking and tobacco use cessation classes in a 12-month period. A qualified doctor or other Medicare recognized professional must give the counseling. Medicare also covers an alcohol misuse screening every year if a provider thinks a beneficiary is misusing alcohol. Medicare can also cover four counseling sessions if your provider believes there is a problem.
If you are a Medicare beneficiary with a substance abuse issue, Medicare Part B covers substance abuse counseling, individual and group therapy and periodic assessments. Medicare can also cover drug testing and medication used to help people recover from opium abuse disorders. To access any of these services speak with your primary care provider.
Since COVID changed the way we interact, Medicare has added Telehealth coverage. Telehealth also called telemedicine is when you use a computer, phone or tablet to have a doctor visit online. The Telehealth benefit includes the telehealth office visit, consultations and psychotherapy. Currently you can have a telehealth visit from your home, car or anywhere that is convenient. After December 31, 2024, telehealth services will be available only in an office or medical facility located in a rural area for most services.
Medicare pays for an annual “Wellness Visit” yearly if you have had Medicare for more than 12 months. This is not a physical exam this is a check to go over your medical and family history, check weight and blood pressure, update a health risk assessment and screen for cognitive issues. There is no cost for this is if your doctor accepts Medicare assignment. If issues are discovered during the Annual Wellness Exam, your doctor may need to schedule more testing or diagnostics and you could be charged for that.
If you have questions or need assistance, please call Aging Matters, 800-392-8771. Because Aging Matters.