The One Medicare Rule That Determines What’s Covered
Call us at 800-847-9680
https://medigapseminars.org/request-a...
https://medigapseminars.org/contact-us/
Podcasts: https://medicarepodcasts.com/
The One Medicare Rule That Determines What’s Covered
Medicare coverage can be confusing and frustrating. Many people wonder if specific procedures will be covered. In this video, I explain how to easily determine what Medicare covers without guessing all the procedures you might need over a lifetime.
Medicare's mandate is to cover everything medically necessary, defined as services or supplies needed to diagnose or treat an illness, injury, condition, or disease according to accepted standards of medicine. This means that if a procedure is needed for treatment or diagnosis, it is likely covered by Medicare.
For those with Advantage Plans, it's important to know that if an insurance company denies coverage, you should ask if the procedure fits the medically necessary criteria. Most appeals against Advantage Plan denials are successful, but only a small percentage of people appeal.
I also discuss what Medicare does not cover, such as long-term care and international insurance.The importance of having some health care insurance for travel and explain the weaknesses of both Original Medicare and Advantage Plans in providing preventive care, dental, vision, and hearing coverage.
Finally, the benefits of Advantage Plans versus Original Medicare plus a supplement, stressing the importance of understanding how each option works, especially for hospital inpatient benefits and cancer care.
If you found this video helpful, please like, subscribe, and hit the bell icon to be notified of new videos. For personalized Medicare guidance, reach out to us. We're here to help!
00:00 – The One Medicare Rule That Determines Coverage
00:55 – Two Parts of this video
03:25 Part One
03:30 – Why Medicare Doesn’t Cover What People Expect
04:00 – What “Medically Necessary” Actually Means
05:00 – How Medicare Decides What’s Covered
05:51 – Why Medicare Advantage Plans Deny Coverage
06:00 – How to Appeal a Medicare or Advantage Plan Denial
06:15 – What Medicare Never Covers (Long-Term Care, Dental, Vision)
07:00 Part 2
07:12 - What Is Long-Term Care (LTC)?
08:00 – How to Get Long-Term Care
09:20 – Recovery Care - Everyone Should Have
11:20 – International Insurance
12:15 – How to get Travel Insurance
14:35 – How to Improve Your Dental, Vision & Hearing (DVH) Coverage.
15:50 - Advantage Plans vs Original Medicare + Supplement
15:50 – Cancer care
19:00 - Hospital Indemnity Plan benefits
20:00 – Advantage Plans and Part B Medications.
20:45 – Last Words / Advantage vs Supplement
Matthew Claassen
CEO, MedigapSeminars.org
Licensed in every state except Massachusetts
Our services are free to you!
#Medicare #Medigap #MedicareAdvantage #MedicareSupplement #MedicareCoverage #MedigapSeminars