Medicare Coverage in Florida

Under the standard plans, hearing aids are not included. Hearing exams are also not paid for by your original Medicare plan. Like dental procedures, you are responsible for hearing-related costs.

Eye exams are not included in your Medicare plan. There are some exceptions. One exception is if you have diabetes. If you have a diabetes diagnosis, your Medicare Part B insurance will pay for annual eye exams. Another exception is if you are at high risk for glaucoma; your Part B will also pay for annual eye exams. In both of these cases, you are responsible for 20% of the cost, and your Part B deductible does apply.

In most cases, eyeglasses and contact lenses are not included in your Part B plan. The exception is if you require corrective lenses after cataract surgery. Then you qualify for one set of contact lenses or one pair of glasses with standard frames per year from a Medicare-enrolled supplier. If you qualify for glasses or contact lenses, you are responsible for 20%, and your Part B deductible does apply. You can pay out of pocket for upgraded frames.

If you are 65 years of age or older, original Medicare does cover cataract surgery. You will be responsible for your deductible and 20% of the cost, and possibly additional fees for the clinic or hospital where the procedure takes place.

Part B of your plan will cover chiropractic care only if you suffer from a spinal subluxation. Manual manipulation is included in your plan. However, additional services, including x-rays, are not covered. If you visit a chiropractor for manual spinal manipulation, you’re responsible for 20% of the cost and deductibles apply.

Medicare only pays for nursing home care that is medically necessary, such as inpatient care at a skilled nursing facility, and does not pay for custodial care. Because most nursing home care is considered custodial, it is not generally covered by your standard plans. Custodial care is assistance that is not medically necessary. This type of assistance can include dressing, cooking, eating, bathing, and using the toilet. If this is the only type of care needed, it is not covered by a standard plan.

Hospice care is included in your Medicare Part A coverage. There is no cost to you, though copayments of $5 or less may be necessary for prescription drugs and other pain relief products. Inpatient care may incur charges of 5% for respite care. To qualify for hospice through Medicare, you must meet all of these conditions:

• Certification from a doctor and a hospice doctor that you are terminally ill and that your life expectancy is less than six months
• Instead of seeking treatment to cure your illness, you accept palliative care to keep you comfortable
• You decline Medicare medical benefits for treatment and sign a statement indicating you are choosing hospice care instead

Part A is Medicare’s hospital insurance. It includes inpatient hospital care, inpatient skilled nursing facility care, home health care, and hospice care.

Part B is your medical insurance. It includes medically necessary services, such as diagnostics and treatment, as well as preventative services, such as vaccinations, flu shots, and annual physicals.

Colonoscopy screenings are included in your Medicare plan. Screenings every 24 months are included for high-risk individuals and every 120 months for those who are not high-risk.

Shingles vaccines are included as part of your Part D plan, which is your prescription drug plan.