Medicare covers the majority of your medical expenses after you turn 65 (and covers some people who are younger than 65 and disabled). But it still requires you to pay deductibles and co-payments, and it doesn’t cover some services at all. Take the following quiz to test your knowledge of what Medicare does and doesn’t cover—and to learn smart ways to fill the gaps. You can look up Medicare’s coverage rules for other items at Medicare.gov.
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Does Medicare cover that?
Does Medicare Cover That?
Next Question
Answer: B
Question 1 of 10
Outpatient prescription drugs?
Medicare doesn’t cover outpatient prescription drugs. If you have traditional Medicare, you can buy a Part D prescription-drug policy to cover drug costs, or you can get a Medicare Advantage plan, which provides medical and drug coverage, from a private insurer.
B
A
Covered by Medicare
NOT covered by Medicare
Question 2 of 10
Care while traveling in another country?
Medicare usually doesn’t cover care you receive while traveling outside of the U.S., except in very limited circumstances (such as on a cruise ship within six hours of a U.S. port). But Medicare supplement (medigap) plans C through G, M and N cover 80% of the cost of emergency care abroad, with a lifetime limit of $50,000. Some Medicare Advantage plans cover emergency care abroad. Or you could buy a travel insurance policy that pays some medical expenses while you’re outside of the U.S. and may even cover emergency medical evacuation, which can otherwise cost tens of thousands of dollars to transport you aboard a medical plane or helicopter.
Question 3 of 10
Preventive care?
Certain preventive care is covered by Medicare without any co-payments, including a “Welcome to Medicare” preventive visit within the first 12 months after you sign up for Part B. This visit provides certain screenings, a flu shot, blood pressure measurement, a simple vision test and a written plan that lets you know what other preventive services you may need. Many screenings are covered by Medicare without a co-payment based on your age, gender and certain risk factors. These include an annual mammogram for women age 40 or older and a yearly PSA test, which screens for prostate cancer, for men age 50 or older.
Answer: A
Question 4 of 10
Hospital stay?
Medicare Part A covers hospital stays, but you’ll have to pay a $1,340 deductible in 2018 before coverage kicks in. You’ll also have to pay a portion of the cost of long hospital stays. The co-payment is $0 for the first 60 days in the hospital during each benefit period (a benefit period ends when you go 60 days without receiving any care in a hospital or skilled nursing facility). But if you stay longer than 60 days during a single benefit period, the co-payment jumps to $335 per day for days 61 to 90 and to $670 per day after that. What’s more, over your lifetime Medicare will only help pay for a total of 60 days beyond the 90-day limit; those 60 days are your “lifetime reserve days.” After that, you will have to pay the full hospital cost. But a medigap policy, a Medicare Advantage plan or retiree health insurance coverage can fill the gap.
Question 5 of 10
Any Medicare doctor you choose?
Traditional Medicare covers all doctors who accept Medicare, but with a caveat: Not all doctors are accepting new Medicare patients. Medigap policies also cover all doctors who accept Medicare. Medicare Advantage plans, on the other hand, usually have a limited provider network. Some Medicare Advantage plans don’t cover visits to out-of-network providers (except in an emergency), while others cover out-of-network doctors and hospitals but charge higher co-payments than if you went in-network for care. If you do get a Medicare Advantage plan, make sure that the doctors and hospitals you plan to use are covered.
Question 6 of 10
Long-term care?
Medicare provides some skilled nursing services, but it doesn’t cover custodial care, such as help with bathing, dressing and other activities of daily living. But you can buy long-term-care insurance to help cover these costs.
Question 7 of 10
Dental care?
Medicare doesn’t cover routine dental visits, teeth cleanings, fillings, dentures or most tooth extractions. Some Medicare Advantage plans cover basic cleanings and x-rays, but they generally have an annual coverage limit (a cap of about $1,500 is common). You could also get coverage from a separate dental insurance policy or a dental discount plan.
Question 8 of 10
Wheelchairs?
Medicare Part B covers manual wheelchairs as durable medical equipment that your doctor prescribes for use in your home. For a powered wheelchair to be covered, however, you must have a face-to-face examination and get a written prescription from your doctor after he or she determines that it is medically necessary for you to have that type of wheelchair. You also must use suppliers that are approved either by original Medicare or by your Medicare Advantage plan.
Question 9 of 10
Hearing aids?
Medicare doesn’t cover routine hearing exams or hearing aids, which can cost as much as $3,000 per ear. But some Medicare Advantage plans cover hearing aids and fitting exams, and some discount programs provide lower-cost hearing aids.
Question 10 of 10
Routine vision care?
Medicare generally doesn’t cover routine eye exams or glasses. (It does cover an annual eye exam if you have diabetes, and it covers eyeglasses after certain kinds of cataract surgery.) However, some Medicare Advantage plans provide vision coverage, or you may be able to buy a separate vision care supplemental policy or a supplemental policy that covers both vision and dental care. One way to cover these costs is to set aside money in a health savings account (if you have an HSA-eligible high-deductible policy) before you sign up for Medicare. You can use money in an HSA tax-free for out-of-pocket medical expenses at any age.
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