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Frequently Asked Medicare Questions

Current Information About the Medicare Program

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Updated August 05, 2013

11. Why Are Preventive Services Important?

Medicare pays for certain healthcare services to prevent illness (such as a flu shot) or help detect an illness in an early stage so it can be managed before getting worse (such as screening for colon cancer). Your doctor can tell you what tests you need and how often you need them.

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12. What Diabetic Supplies Does Medicare Cover?

Medicare covers some diabetes supplies, including:

  • blood glucose test strips
  • blood glucose monitor
  • lancet devices and lancets, and
  • glucose control solutions for checking the accuracy of test strips and monitors.

Medicare may limit how much or how often you get these supplies. Regular Medicare does not cover insulin. You will have to pay 100% for insulin (unless used in an insulin pump), syringes, and needles, unless you have enrolled in a Medicare Part D prescription drug plan or have a Medicare Advantage plan with drug coverage.

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13. Does Medicare Cover Dental Services?

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Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or dentures. Medicare Part A may pay for some dental services that you get when you are in the hospital. Some Medicare Advantage plans may include dental benefits as an added benefit. Check with your Medicare Advantage plan directly to see what dental services are covered, if any.

14. Does Medicare Cover Eye Health Services?

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Medicare covers services for the diagnosis and treatment of eye disease both in your doctor’s office and the hospital. This includes the treatment of glaucoma and the removal of cataracts.

Medicare does not cover the cost of a routine eye refraction or the cost of eyeglasses or contact lenses.  However, following cataract surgery with an intraocular lens, Medicare will help pay for cataract glasses, contact lenses, or intraocular lenses provided by an ophthalmologist.

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15. I Lost My Medicare Card. How Can I Get a New One?

If you have Original Medicare (Part A and Part B), call Social Security at 1-800-772-1213, or visit www.socialsecurity.gov/medicarecard. When you request a replacement Medicare card online or on the phone, you will need:

  • Your name as it appears on your most recent Social Security card
  • Your Social Security Number
  • Your date of birth

You should receive your replacement Medicare card in the mail in about 30 days. You can also visit your local Social Security office. If you are enrolled in a Medicare Advantage Plan and lost your card, call your plan’s customer service number for a replacement.

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16. What If I Need a Drug That Isn’t on the Formulary or Costs Too Much?

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According to Medicare, if you need a drug that is not on your Part D formulary, or that is on the list but you think it should be covered for a lower copayment, you can do the following:

  • Contact the plan and ask for an exception. You will probably have to provide information from your doctor about why you need the drug your plan won’t cover.
  • If your plan denies the exception, you can appeal. Your Part D plan must give you information on how to appeal.

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17. My Part D Prescription Plan Has a Drug Formulary with Tiers. What Does It Mean?

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Drugs on a Part D formulary are usually grouped into tiers, and your copayment is determined by the tier that your medication is on. A typical Part D drug formulary includes three tiers.

Tier 1 has the lowest co-payment and usually includes generic medications.

Tier 2 has a higher co-payment than tier 1 and usually includes preferred brand name medications.

Tier 3 has the highest co-payment and usually includes non-preferred brand name medications. Your plan may place a medication in tier 3 because there is a similar drug on a lower tier of the formulary that may provide you with the same benefit at a lower cost.

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18. Does Medicare Cover Me When I Travel Outside the United States?

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The Original Medicare Plan generally doesn’t cover health care while you are traveling outside the U.S. and its territories. Some Medigap policies Foreign Travel Emergency health care coverage when you travel outside the U.S.

Some Medicare Advantage plans may provide worldwide coverage benefits for health care needs when you travel outside the United States. Before traveling outside the country, check with your Medicare Advantage plan regarding travel benefits.

If you know that you will not have Medicare-related coverage when you travel, you may want to consider purchasing a temporary travel health insurance policy.

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19. I Can't Afford My Medicare and Drug Coverage Premiums. What Can I Do?

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You have several options if you need help with medical and drug costs, such as premiums, deductibles, and other out-of-pocket expenses. These options include:

  • Medicaid
  • Medicare Savings Program
  • Extra Help and Low-Income Subsidy
  • State Pharmaceutical Assistance Program
  • Pharmaceutical Assistance Program

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20. Where Can I Get Answers to My Questions About Medicare?

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I will be happy to answer questions about Medicare. If I don’t have the answer, I will research it for you or provide you with resources that are credible and up to date. If the answer to your question is of interest to other readers, I may post it as a FAQ or in my Blog or newsletter.

Although I may not always be able to advise you about your specific health insurance situation, I can let you know some of your options and how to find the information you need.

You also can get some of your Medicare questions answered directly from the “horse’s mouth” at the Medicare Support Center.

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Do you have questions about Medicare? Are you having a problem with Medicare coverage or a Medicare claim? Not sure where to turn?

Medicare Questions and Problems: Where to Get Help will show you the six best resources for answering your Medicare questions and resolving your Medicare problems.

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