Does Medicare Cover Weight Loss Programs?
Yes, in some cases. Medicare Part B covers some in-office weight loss programs, including nutrition and physical activity counseling, and it offers exercise equipment under Part B for home-use. Medicare Advantage Plans may also cover in-office weight loss programs, but not all of them do. See here for a list of Medicare Advantage Plans that cover in-office weight loss programs.
What kinds of Medicare coverage are available?
Medicare has several types of coverage. Medicare Part A covers inpatient hospital services, skilled nursing facility services, and hospice care. Medicare Part B covers doctors' services, outpatient hospital services, and medical equipment. Some Medicare Advantage Plans also offer prescription drug coverage.
Medicare Part A and Part B are voluntary programs. There is no penalty for not enrolling in Part B, and you can enroll at any time. However, if you enroll in Part B, you are locked into a 2-year enrollment period. During this period, you cannot enroll in a Medicare Advantage Plan that includes Part A. Part B is not available to individuals who are covered by a government or employer health plan. Part A is not available to individuals covered by a government or employer health plan.
What are the benefits of Medicare?
Medicare provides coverage for:
Outpatient hospital services, including physician and other related services
Skilled nursing facility services, including physical, speech, and occupational therapy, and other related services
Hospital and skilled nursing facility care after a 90-day hospital stay
Home health services
Part B outpatient medical services, such as physician and other related services, medical supplies, and equipment
Some products and services for people with disabilities, such as durable medical equipment and outpatient physical therapy
Rural health clinic and Federally-qualified health center services
A wide range of preventive services, including screenings, immunizations, and counseling
Diagnostic tests, such as mammograms and colonoscopies
Inpatient mental health care
Some disease management and wellness services
Medicare Advantage and Medicare Cost Plans
Medicare Advantage plans (also called “Part C” or “Medicare Health Plans”) are health plans offered by private insurance companies that contract with Medicare to provide all Part A and Part B benefits. Each Medicare Advantage plan has its own network of doctors, hospitals, home health agencies, and prescription drug plans. Medicare Advantage plans typically have lower monthly premiums but higher out-of-pocket costs for services than Original Medicare.
Medicare Cost plans (also called “Part D” or “Medicare Prescription Drug Plans”) are prescription drug plans offered by private insurance companies. In some areas, there may be no Medicare Cost plans available, in which case you will need to participate in a Medicare Advantage plan, or consider a prescription drug plan offered by one of the other companies that offer Part D coverage.
It is important to understand that Medicare Advantage and Medicare Cost plans are not Medicare. They are private health plans that are offered as an option for those who enroll in Medicare.
What are the costs of Medicare Part B and Part D?
Monthly premiums for Medicare Part B are usually deducted from your Social Security check. Part B premium amounts are based on your income as reported on your Federal Income Tax returns in the prior two years, but the minimum Part B premium is $104.90 per month (in 2017, it was $121.80 per month for the first three months of the year).
Premiums for Part D plans are deducted from Social Security payments, and can be adjusted annually. The amount of the premium varies according to the coverage and plan you choose. Some Part D plans charge a higher premium if you don't choose a generic drug when a brand-name drug is available. This is called a “step-therapy” or “adverse-selection” clause.
You can learn more about the costs for Medicare Part B and Part D here.
Medicare Advantage Plans
Medicare Advantage plans are offered by private health insurance companies, and are not part of Medicare. Medicare Advantage plans are designed to offer a range of choices, including HMOs, PPOs, and local service networks.
Medicare Advantage plans typically offer prescription drug coverage, which is a separate benefit from the Part D prescription drug plan available under Original Medicare.
The Medicare Advantage Plans you choose will depend on your health care needs, personal preferences, and the availability of coverage where you live.
Some Medicare Advantage Plans may be offered by employers or unions, or offered directly by the health insurance company.
Medicare Advantage plans have different benefits and costs. They also often have different monthly premiums and out-of-pocket costs when compared to Original Medicare.
Medicare Advantage plans can offer benefits that aren't covered by Original Medicare, such as dental care, eye care, and transportation. They also may have extra services that can help you stay healthy.
Some Medicare Advantage Plans have a network of doctors, hospitals, home health agencies, and prescription drug plans. The use of the network is voluntary. Original Medicare is not part of a network.
Medicare Advantage plans may have an annual deductible (a yearly amount that you pay before coverage begins) and a monthly premium. You must meet your deductible before your plan pays for covered services. The plan may pay on a fee-for-service or managed care basis. You can find out more about Medicare Advantage Plans here.
Medicare Cost Plans
Medicare Cost Plans (also called “Part D” or “Medicare Prescription Drug Plans”) are prescription drug plans offered by private insurance companies. In some areas, there may be no Medicare Cost plans available, in which case you will need to select a prescription drug plan offered by one of the other companies that offer Part D coverage.