If you wear prescription glasses and they’re considered “medically necessary,” you may be eligible for coverage through certain insurance plans. For instance, if you require prescription glasses after cataract surgery, this may qualify as medically necessary care. However, it’s important to note that Original Medicare Parts A and B typically don’t cover most prescription glasses, contact lenses, or other eyewear. Understanding the distinction between what’s covered and what’s not is essential to ensuring you get the coverage you need.

If your prescription glasses aren’t considered a medical necessity, Medicare Advantage (Part C) plans may still offer coverage for eyeglasses, contact lenses, and prescription sunglasses. The specific benefits and costs can vary by plan, so it’s important to discuss the details with your provider. Many plans also include coverage for routine eye exams, which could be an added benefit for your eye care needs.

4 Important Medicare Gaps You Need to Know About

While many people are familiar with the coverage Medicare provides, it’s equally important to understand what it doesn’t cover. Here are four key areas where Medicare falls short:

1. Prescription Drugs: Original Medicare doesn’t include prescription drug coverage. However, you can add this coverage through Medicare Part D or choose a Medicare Advantage plan, which bundles both medical and drug coverage.
2. Long-Term Care: Medicare covers certain nursing services but doesn’t provide for custodial care, such as assistance with daily activities like bathing and dressing. For this type of care, long-term care insurance is your best option.
3. Deductibles and Copays: Even with Medicare Part A and Part B covering some hospital stays and doctor visits, you’ll still be responsible for deductibles and copayments. Medicare Advantage plans, offered by private insurers, can help fill in these gaps.
4. Dental Care: Routine dental services, such as checkups, cleanings, fillings, dentures, and extractions, aren’t covered by Medicare. Some Medicare Advantage plans may offer limited dental coverage, such as basic cleanings and X-rays, but often with coverage caps.

If you’re unsure about your Medicare options or need assistance navigating these gaps, a Health Plans of America insurance professional can guide you through the process and help you find the right coverage. Reach out today!

In today’s world, where technology is everywhere, it can be difficult to tell if you’re falling victim to a scam. When it comes to your health, however, scams and fraud can have a serious impact on your peace of mind and overall well-being.

As we begin the New Year, here are some simple yet effective steps you can take to protect yourself from Medicare scams:

Stay Alert for Suspicious Activity
Be vigilant and trust your instincts. If something feels off, take a moment to assess the situation. Scammers often rely on pressure and urgency, so don’t hesitate to pause and question their motives.

Ask Questions and Seek Trusted Advice
If you’re ever uncertain, ask questions. Whether it’s about a phone call, email, or in-person interaction, probing deeper can help expose scammers. Consult with a trusted friend, family member, or advisor to get a second opinion.

Review Your Statements Regularly
Keep an eye on your Medicare Explanation of Benefits (EOB) and monthly statements. Regularly reviewing these documents ensures you catch any discrepancies or fraudulent activity early on.

Consult Your Doctor, Not Strangers
Scammers may try to convince you that they have your best interests at heart. However, your primary care doctor is the true expert when it comes to your health and care options. Always rely on them for medical advice.

Report Suspicious Activity
If you suspect you’ve encountered a scam, report it. Chances are, you’re not the only one. By reporting the issue, you help protect yourself and others in your community from potential fraud.

With so much information out there, knowing where to start can feel overwhelming. That’s where Health Plans of America can help. They provide the resources and guidance you need to make informed decisions with confidence.

Are you confident that you’re maximizing the value of your health care coverage? With the amount of money you invest in insurance, it’s crucial to ensure you’re getting the care and benefits you deserve. At Health Plan Market, we understand how important it is to make the most of your plan. That’s why we’ve put together three essential tips to help you navigate your health coverage:

1. Understand Your Benefits
Make sure you’re fully aware of all the services included in your plan. Don’t forget to check what should be covered by your insurance so you can avoid paying for unnecessary services that are already part of your coverage.

2. Choose an In-Network Physician
Visiting out-of-network doctors can lead to higher costs for your medical services. By sticking with in-network providers, you can significantly reduce your expenses and get the care you need at a more affordable rate.

3. Meet Your Deductible Before Scheduling Doctor Visits
Once you’ve met your deductible, your insurance will cover any additional medical expenses. You may still need to pay a co-payment, but that’s far less than paying full price for your services.

4. Take Advantage of Discounts and Special Programs
Many health insurers partner with fitness centers to offer discounted memberships. You might also have access to exclusive health apps or online portals designed to support your fitness goals.

In today’s world, where health insurance is essential, making the most of your benefits is key. The more you understand your options, the better you can manage your health care costs. Reach out to a licensed professional at Health Plan Market today and discover how you can start saving!