Always be on the alert for what your Medicare plan does not cover.
Just like with other health insurance coverage, Medicare insurance doesn’t necessarily cover everything. Obviously, you know what your deductibles and co-pays are, but you also need to keep a close eye out for which medical providers are in your network.
Remember, just because the doctor will accept the insurance does not necessarily mean he is in the network.
Also, insurers don’t automatically pay a claim just because you are wheeled into an operating room. For example, insurers might not pay for all types of reconstructive surgery and never for purely cosmetic surgery. Other types of surgery may be considered too experimental in the eyes of the insurer. It is always wise to pre-authorize a procedure with the insurer whenever possible.
Not only may you be required to pay deductibles up front, but hospitalization can also bring unpleasant surprises after you are discharged. For example, your physician and the hospital may be in your plan’s network, but not every professional who attends to your needs may be in your network. This may result in bills that you are responsible to pay. Another issue to keep in mind is that the determination of what constitutes an emergency is the insurer’s decision, not yours.
Please consult with your local licensed insurance professional to make sure you are properly covered.
Andrew Bird, an agent at Financial Concepts in Mesquite, specializes in Medicare and Insurance services. Andrew Bird can be reached at 702-346-7025 or by email at Abird@rconnects.com