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Health Line
5 days ago
- Health
- Health Line
Does Medicare Cover Foot Care?
Key takeaways Medicare covers foot care for injuries, emergencies, and treatment for certain conditions. In most cases, Medicare doesn't pay for routine foot care unrelated to a serious medical condition. People with diabetes can have routine foot care covered under Part B, including specialized shoes and shoe inserts. However, Medicare can cover routine foot care for people with diabetes if it's considered medically necessary. 'Foot care' can refer to treatment for serious conditions that affect the health of your feet or everyday concerns like calluses. Medicare separates these two kinds of foot care and only covers treatments that are medically necessary. In most cases, Medicare doesn't pay for routine foot care unrelated to a serious medical condition. However, you might have additional coverage for foot care if you have a Medicare Advantage plan. What kind of foot care does Medicare cover? Medicare covers foot care that's considered medically necessary. For care to be considered medically necessary, it needs to be prescribed by a physician or other licensed healthcare professional. Generally, Medicare will cover services you receive from a qualified podiatrist, although care from other physicians and healthcare professionals might also be covered in some cases. When you receive medically necessary foot care as an outpatient, it will be covered under Part B. Some examples of foot care that would be considered medically necessary include treatment of: wounds injuries infected nails hammer toe heel spurs If you receive foot care while you're admitted to the hospital, it will be covered under Part A. Just like with Part B coverage, the foot care you receive in the hospital must be considered medically necessary to be covered. No matter where you receive foot care, it must be performed by a Medicare-approved healthcare professional to qualify for coverage. Does Medicare Part C cover more foot care? Depending on your Part C, or Medicare Advantage, plan, you might have additional foot care coverage. Medicare Advantage plans are required to cover all of the same services as parts A and B. In many cases, Medicare Advantage plans offer additional coverage, which could include routine foot care. Check with your plan for specific coverage details before you go to your foot care appointment. What types of foot care are not covered? Medicare does not cover routine foot care, such as treatment for flat feet or fittings for orthopedic shoes. Routine foot care also includes hygiene and upkeep services, such as: nail trimming treatment of calluses removal of dead skin foot soaks application of lotions This applies to Medicare parts A and B, also known as Original Medicare. A Medicare Advantage plan might offer coverage for some of these services, including orthopedic shoes. What is covered for diabetes foot care? Some of Medicare's foot care rules are different if you have diabetes. Notably, people with diabetic peripheral neuropathy may receive a foot exam once every 6 months. Diabetes can lead to an increased risk of serious foot problems. Many issues are caused by nerve damage called neuropathy. Over time, this nerve damage can cause you to no longer feel any sensation in your feet. This can make it difficult to know if you've injured your foot or have a wound. People with diabetes are also susceptible to skin damage and ulcers, which can become infected. Additionally, diabetes can affect your circulation and reduce the blood flow to your ankles, feet, and toes. Together, all these factors can lead to serious infections that could eventually result in the need for a foot amputation. Medicare Part B covers foot care services for people with diabetes. These services include: nail care removal of calluses and corns specialized shoes and inserts You'll need a diagnosis of diabetic neuropathy to have these services covered by Medicare. If your podiatrist recommends it, you can be covered for one pair of custom-molded or extra-depth shoes each year, too, including the fitting appointments. Medicare will also pay for inserts to help your regular shoes provide the right support. If you prefer inserts instead of therapeutic shoes, you can get two pairs of custom-molded inserts or three pairs of extra-depth inserts each year. How do I qualify for these benefits, and what rules apply? To qualify for coverage, your condition needs to be under physician treatment. Your healthcare professional will need to show documentation that you're receiving treatment for a condition that requires foot care. For Medicare to begin paying, you'll need to be receiving active care for 6 months for that condition. Make sure you're enrolled in either Medicare Part B or a Medicare Advantage plan. Medicare Part A only covers hospital and long-term care expenses. Your podiatrist or other foot care professional must be enrolled in Medicare and accept assignment. If you're using a Medicare Advantage plan, you might need to use a healthcare professional who's in your plan's network. What costs should I expect? Your costs will depend on whether you have Original Medicare or a Medicare Advantage plan. Part B Under Original Medicare, you'll pay 20% of the Medicare-approved cost for services once you meet your deductible. In 2025, the Part B deductible is $257. Once you've met your deductible, Medicare will typically cover 80% of the cost of medically necessary foot care services and medical equipment, including diabetic footwear, if you meet certain conditions. You'll also need to pay the Part B premium. Most people will pay a premium of $185 per month in 2025. You can search for the Medicare-approved costs of foot care in your area on the Medicare website. Part C (Medicare Advantage) When you use a Medicare Advantage plan, the costs will vary depending on your plan's rules. You might have different coinsurance costs, a different deductible amount, or a different monthly premium. You might also need to stay in network to avoid higher costs. If your Advantage plan offers additional foot care coverage beyond Original Medicare, the costs will be outlined in your plan details. Medigap Medigap plans do not provide added benefits for foot care. However, Medigap plans might cover some of the coinsurance or other out-of-pocket costs leftover from your Part B coverage.
Health Line
16-06-2025
- Health
- Health Line
What Is the Medigap Open Enrollment Period?
The Medigap open enrollment period (OEP) is your first opportunity to enroll in a Medigap plan. During the Medigap OEP, you cannot be denied Medigap coverage due to a preexisting health condition. Medicare supplement insurance, or Medigap, is a type of private insurance that helps cover the out-of-pocket costs of Original Medicare. As with other parts of Medicare, Medigap has a set enrollment period for people new to Part B. In this article, we discuss the Medigap open enrollment period, its benefits, and what happens if you miss this window. When is the Medigap open enrollment period? The Medigap OEP is a one-time, 6-month window that begins on the first of the month you are enrolled in Part B and are age 65 years or older. If you sign up for Medigap during the Medigap OEP, you can join any plan in your state. Additionally, insurers cannot deny you coverage or charge you a higher rate due to a preexisting health condition. If you wait until after the Medigap OEP to join a plan, insurers are under no obligation to sell you a plan or charge you the standard rate. Insurers can evaluate factors like your medical history and age when deciding whether to sell you a plan. This process is known as medical underwriting. The Medicare website has a tool you can use to determine when and whether you're eligible to enroll in Medigap. Benefits of the Medigap open enrollment period If you're considering joining a Medigap plan, there are various benefits to doing so during the Medigap OEP instead of waiting. These include the following: You can join any plan in your state regardless of your health status. You'll have access to a wider array of plan options at lower costs. Your coverage will begin immediately (with the exception of expenses related to preexisting conditions, which are subject to a 6-month waiting period before the Medigap policy starts covering them). What happens if I miss the Medigap open enrollment period? As mentioned earlier, if you miss the Medigap OEP, you could be subject to medical underwriting when you try to enroll in a Medigap plan, resulting in fewer options and higher costs. However, there are situations where this may not apply, known as 'guaranteed issue rights.' These rights apply in certain cases where a person loses coverage or experiences a change in coverage. If you have guaranteed issue rights, an insurance company needs to sell you a Medigap policy, regardless of whether you have a preexisting condition, and they can't charge you more due to your health status. Some circumstances where guaranteed issue rights might come into play include: losing Medicare Advantage coverage due to: your plan leaving Medicare your plan leaving your area you moving out of the plan's area losing secondary insurance through an employer while enrolled in Original Medicare losing coverage due to the bankruptcy of your Medigap provider Some states have different Medigap rules. If you have questions about Medigap open enrollment in your specific state, consider reaching out to your local State Health Insurance Assistance Program (SHIP). Frequently asked questions How long is open enrollment for Medigap? Open enrollment for Medigap lasts 6 months. If you're age 65 years or older, the Medigap OEP begins on the first of the month that you have Part B coverage. Open enrollment for Medigap lasts 6 months. If you're age 65 years or older, the Medigap OEP begins on the first of the month that you have Part B coverage. Can I add a Medigap policy at any time? Yes, you can sign up for a Medigap policy at any time. Unlike Medicare Advantage plans, which require waiting for specific enrollment periods to join, switch, or drop coverage, you don't need to wait for a set enrollment period with Medigap. However, if you sign up for a Medigap plan outside of the Medigap OEP, insurance companies are free to deny you coverage or charge you a higher rate based on your health. Yes, you can sign up for a Medigap policy at any time. Unlike Medicare Advantage plans, which require waiting for specific enrollment periods to join, switch, or drop coverage, you don't need to wait for a set enrollment period with Medigap. However, if you sign up for a Medigap plan outside of the Medigap OEP, insurance companies are free to deny you coverage or charge you a higher rate based on your health. Summary The Medigap open enrollment period (OEP) is a 6-month window that starts at the beginning of the month when you're age 65 years or older and first have Part B. During the Medigap OEP, you can buy any Medigap plan offered in your state regardless of whether you have a preexisting health condition.
Health Line
09-06-2025
- Health
- Health Line
Will Medicare Pay for Contact Lenses?
In most circumstances, Original Medicare (parts A and B) doesn't pay for contact lenses. But some Medicare Advantage (Part C) plans may offer vision coverage. Original Medicare covers medical and hospital costs, but vision, dental, and hearing care aren't usually covered. This means you likely won't get financial help from Medicare to pay for your contact lenses. However, there are a few exceptions. For example, Medicare may cover the cost of contact lenses after cataract surgery. And some Medicare Advantage plans provide vision coverage. This article reviews how contact lenses might be covered under Medicare. Does Medicare cover contact lenses? While Medicare covers some vision services, it doesn't usually pay for eye exams or contact lenses. Some of the vision services that Original Medicare (parts A and B) may cover include: an annual glaucoma test for people at high risk (including those with diabetes or a family history of glaucoma) a yearly exam to test for diabetic retinopathy for those with diabetes cataract surgery diagnostic testing or screenings for macular degeneration Medicare Part B coverage Medicare Part B covers most outpatient medical services, such as doctor's visits, durable medical equipment, and preventive services. It doesn't usually cover contact lenses. However, there is one exception. If you have cataract surgery, Medicare Part B will cover one pair of corrective contact lenses after your surgery. When you have cataract surgery, your eye doctor will insert an intraocular lens, which can sometimes change your vision. As a result, you'll likely need new contact lenses or eyeglasses to correct your vision. Even if you wear glasses already, you'll most likely need a new prescription. It's important to know that Medicare will pay for new contact lenses after each cataract surgery with an intraocular lens insertion. Normally, eye doctors will only perform surgery on one eye at a time. If you have surgery to correct a second eye, you can get another contact lens prescription at that time. However, even in this situation, the contact lenses aren't totally free. You'll pay 20% of the Medicare-approved amount, and your Part B deductible applies. Also, you'll have to make sure you order contacts from a Medicare-approved supplier. If you usually order your contact lenses from a certain supplier, be sure to ask if they accept Medicare. If not, you may need to find a new supplier. Part C coverage Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare that combines Part A and Part B. To attract subscribers, Medicare Advantage plans offer some combination of dental, hearing, vision, and even fitness benefits. Medicare Advantage plans can vary greatly in the vision coverage they offer. According to health policy research nonprofit KFF, 97% of Medicare Advantage plans offer some level of vision coverage in 2025. Even with coverage, a person can still expect to have out-of-pocket costs. In 2018, Medicare Advantage enrollees who used their vision benefits spent an average of $194 on vision services. Examples of services Medicare Advantage plans may cover related to vision include: routine eye exams exams for fitting frames or contact lens prescriptions costs or copayments for contact lenses or eyeglasses Medicare Advantage plans are often region-specific because many involve using in-network providers. To search for available plans in your area, visit coverage finder tool. If you find a plan you're interested in, click on the 'Plan Details' button, and you'll see a list of benefits, including vision coverage. Often, you're required to purchase your contacts from an in-network provider to ensure the plan will cover them. Costs and other savings options The average cost of contact lenses can vary. Contacts range in features from daily disposable lenses to those that correct astigmatism, called toric lenses. In general: Daily disposable lenses are more expensive than monthly lenses. Multifocals are more expensive than distance-only or monovision lenses. Toric contacts for astigmatism are more expensive than spherical contacts. You'll also pay for accessories that help you care for your contacts. These can include contact lens cases, solutions, and eye drops — if you have dry eyes. It's a little harder to get help paying for contacts compared to eyeglasses when you have vision needs. Because glasses last longer than contacts and can be used and reused from donated materials, there are more organizations that may help you get a pair of free or low cost eyeglasses. However, you can save money on your contacts through these approaches: Order online: Many online contact lens retailers offer cost savings compared to ordering at a retail store. Just make sure you're using a reputable online source. You can also ask your retail store of choice if they'll match online prices. Purchase an annual supply: Although there's a hefty upfront cost, purchasing an annual supply of contacts often offers the lowest cost in the end. This is particularly true when ordering from online retailers. Look into whether company rebates could help you save. Look into Medicaid eligibility: Medicaid is a federal and state collaborative program that offers financial assistance for a number of medical costs, including vision and contact lenses. Eligibility is often income-based, and you can check your eligibility or learn how to apply on the Medicaid website. However, Medicaid may not cover contact lenses. Safety tip for wearing contact lenses When you do get your contacts, it's important that you use them as directed. Wearing them longer than recommended can increase your risk for eye infections, which can be both painful and costly to treat.
Health Line
02-06-2025
- Business
- Health Line
How Much Will Medicare Cover If I Need a CT Scan?
Key takeaways Medicare will cover any medically necessary diagnostic tests, including CT scans. Inpatient CT scans are typically covered by Part A, while outpatient CT scans are usually covered by Part B. Part C (also called Medicare Advantage) plans include at least the same level of coverage as parts A and B. Medigap plans can help decrease out-of-pocket costs associated with Original Medicare coverage for CT scans. Medicare will cover any medically necessary diagnostic tests you need. This includes computed tomography (CT) scans. Your exact coverage depends on where you have the test and which Medicare part covers it. Part A coverage for CT scans Part A is hospital insurance. It covers the care you receive during an inpatient stay at: a hospital a skilled nursing facility another inpatient facility This includes any tests your doctor orders during your stay. So, if you receive a CT scan in the hospital, Part A will cover it. In this situation, the cost of a CT scan will go toward your Part A deductible. In 2024, the Part A deductible is $1,632 for each benefit period, and in 2025, it is $1,676. Once you've met this deductible, Part A will cover all tests and procedures during your stay, with no coinsurance costs during the first 60 days of hospitalization. Part B coverage for CT scans Part B is medical insurance. It covers outpatient care at multiple types of healthcare facilities, such as: doctor's offices urgent care centers health centers outpatient clinics outpatient labs and testing facilities surgical centers Part B will cover your CT scan no matter which outpatient setting you have it in. You'll have coverage as long as the facility participates in Medicare and a doctor orders the scan. The Medicare website has a tool for checking which facilities and providers participate in Medicare in your area. After you meet your Part B deductible, Medicare will pay 80% of the approved cost of your CT scan. You'll be responsible for the other 20%. The Medicare Part B deductible is $240 in 2024 and $257 in 2025. Part C coverage for CT scans All Part C plans cover CT scans. However, many Part C plans have networks. You might pay much higher costs for leaving your plan's network. Sometimes, you may not have out-of-network coverage, even if the facility participates in Medicare. The deductible and any copayment or coinsurance amount depend on your specific plan. If possible, contact your insurance company ahead of time to get an estimate of how much this test will cost. Medigap coverage for CT scans Medigap is supplemental insurance that you can buy to cover your out-of-pocket costs from Medicare. Depending on your Medigap plan, you may be able to get coverage for your: Part A deductible Part B deductible Part A copays and coinsurance Part B copays and coinsurance That means that Medigap would cover any costs associated with your CT scan that would typically be your responsibility. Medigap plans have a monthly premium on top of your Medicare Part B premium. So, while you'll pay more each month, the costs will be covered when you need a service like a CT scan. The bottom line Part A will cover your CT scan if you have it during an inpatient hospital stay, and Part B will cover it when you have it as an outpatient. Part C will also cover a CT scan, but you'll typically need to stay within your plan's network. If Medicare doesn't cover your CT scan and you think it should, you can file an appeal. An appeal will give you several chances to explain why the CT scan was medically necessary and see whether Medicare will cover it.
Medical News Today
02-06-2025
- Business
- Medical News Today
IV infusions and Medicare: Coverage details
Original Medicare provides coverage for IV infusion therapy when a doctor determines it to be medically necessary, both in a clinic setting and at home. Medicare Advantage (Part C) plans need to offer the same services as Original Medicare, though a person's out-of-pocket costs will differ and will depend on their plan. This article discusses coverage options for IV infusions through Medicare. When does Medicare pay for IV infusions? Medicare Part A, Part B, and Medicare Advantage (Part C) plans generally all cover IV infusions if these are medically necessary. However, whether Medicare deems a person's IV infusion medically necessary depends on each case. That said, examples of medications or other liquids that healthcare professionals administer via an IV include : chemotherapy drugs Immunotherapy drugs targeted therapy drugs anti-nausea medicines hydration fluids antibiotics Any IV infusion must last at least 15 minutes to qualify under Medicare. In addition, Medicare will cover hydration therapy when medically necessary with an IV infusion, which is considered part of the same treatment as long as the hydration therapy lasts 20 to 30 minutes or less. Does Medicare cover IV infusion at home? Medicare Part B covers the equipment for home IV infusion under its durable medical equipment (DME) benefit. In addition, Part B will cover the infusion drugs themselves and support the infusion through nursing visits, caregiver training, and patient monitoring. Are infusions covered by Medicare Part D? Medicare Part D covers drugs that a person can administer themselves. Because individuals cannot administer their infusion, their IV infusion will fall under the coverage of Part B. How much does an IV infusion cost? Original Medicare comprises parts A and B. Part A covers hospitalization and general Medicare care. A person receiving an IV infusion during their hospital stay must meet a 2025 deductible of $1,676 before coverage begins. In most cases, people do not pay a premium for Part A. A person receiving infusion therapy under Part B must pay a premium that starts at $185, depending on their income, and meet a deductible of $257. After that, Part B pays for 80% of infusion costs. A person enrolled in a Part D plan will get the same coverage as under Part A and Part B. However, private insurers manage these plans, which have different premiums, deductibles, and coinsurances. According to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for Part C plans is around $17 in 2025. How much does home infusion therapy cost? How much IV infusion, whether at home or in a medical setting, might cost out of pocket before and after insurance depends on the type someone needs and the duration of the treatment. One 2023 review estimated the cost per day for home infusion to be $122 and for inpatient infusion to be $798. This review also examined six studies, finding that home infusion therapy could save significantly more money than inpatient infusion. One study reported savings of over $40,000 per patient, while another projected nearly $3 billion in savings for Medicare over 5 years. Medicare parts A, B, and C (Medicare Advantage) cover IV infusions if doctors deem them medically necessary. Part B also includes home IV infusion equipment under the durable medical equipment benefit, including infusion medications, nursing visits, caregiver training, and patient monitoring. A person enrolled in Part C will get equivalent coverage to parts A and B. A person needs to verify their hospital status — whether the hospital classifies them as an inpatient or outpatient — with their healthcare team. This can influence their out-of-pocket expenses and determine which part of Medicare will cover the services. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
