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Telehealth

Posted on May 9, 2019 at 10:10 PM

Telehealth use jumped 53% from 2016 to 2017, outpacing all other sites of care, according to a new report. But Medicare pays for telehealth services only if the beneficiary is in a rural area with a shortage of health professionals or lives in a county outside of a metropolitan area. It also limits which providers can bill for such services.


Medicare Part B (Medical Insurance) covers certain telehealth services. You pay 20% of the Medicare-approved amount for your doctor or other health care provider’s services, and the Part B deductible applies.


Your Cost: To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

Other insurance you may have

How much your doctor charges

Whether your doctor accepts assignment

The type of facility

Where you get your test, item, or service


Telehealth services include office visits and consultations that are provided using an interactive 2-way telecommunications system (with real-time audio and video) by a doctor or certain other health care provider who isn’t at your location.

These services are available in some rural areas, under certain conditions, but only if you're located at one of these places:

A doctor's office

A hospital

A critical access hospital (CAH)

A rural health clinic

A federally qualified health center

A hospital-based or critical access hospital-based dialysis facility

A skilled nursing facility

A community mental health center


Gaps In Medicare

Posted on February 15, 2017 at 7:00 AM

Medicare DOES NOT cover the cost of routine dental care, eyeglasses, hearing aids, and most long-term services and supports.


Specifically, Medicare does not cover custodial care, which means the care for people who are unable to live independently, but do not have an acute condition requiring skilled medical services. For example, people with Alzheimer's disease or other dementias living in nursing homes would not have their residential bills covered by Medicare. If they suffered a heart attack, or came down with pneumonia, Medicare would cover medical expenses. Learn more at the National Academy of Social Insurance.


You can also visit Medicare.gov to find what Medicare covers and what gap protection you may need.


Medicare Part A & Part B doesn't cover everything. If you need certain services Medicare doesn't cover, you'll have to pay for them yourself unless you have other insurance or you're in a Medicare health plan that covers them.


Even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments.

 

https://www.medicare.gov/what-medicare-covers/not-covered/item-and-services-not-covered-by-part-a-and-b.html

 


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