A non-government website

To speak to a Licensed Insurance Agent

(TTY 711)

Mon - Fri, 9 AM - 6 PM EST

Free Services That Medicare Covers in 2022

Medicare free services

The government-run health insurance program in the US is called Medicare. A person may qualify for Medicare coverage if they are 65 years of age or older or have specific medical conditions. The Centers administer Medicare for Medicare and Medicaid Services, categorizing free Medicare services into parts A, B, C, and D.

Medicare: Does it provide free services?

Medicare is a federal insurance program for seniors and persons with specific medical problems. The program is not completely or entirely free but tries to help seniors to pay for healthcare expenses.

The costs associated with each component of Medicare vary and may include coinsurance, deductibles, and monthly fees.

Before an insurance company starts paying for treatment, the policyholder is responsible for paying an amount known as the deductible out of their pocket.

Coinsurance is when a patient contributes a portion of the cost of a procedure or consultation.

Instead of paying a percentage, a person pays a fixed amount known as a copayment for a service or prescription medicine.

Each of these elements may increase medical care costs under a Medicare plan.

We describe the Medicare free services of the various Medicare parts in this post.

Medicare Offers 10 Free Services

Medicare is not an exception to the rule that there is no such thing as a free lunch since it does not exist. While the government program covers most medical bills, participants still have to pay hundreds of dollars in premiums, deductibles, copays, and other out-of-pocket charges each year.

But the Affordable Care Act (ACA), which also includes certain significant Medicare benefits, increased access to preventive care services for free. Here is a list of some tests and screenings Medicare beneficiaries receive at no cost.

An annual wellness checkup

If you have had Medicare Part B for over a year, you qualify for this free exam. Your medical history will be examined, your current list of physicians and prescriptions will be brought up to date, measurements of your height, weight, blood pressure, and other vital signs will be taken, and the attending physician will provide you with individualized recommendations regarding your health and potential courses of treatment.

Although the free appointment is available, the doctor may recommend additional tests or treatments that could incur a charge or deductible.

Mammogram

Free screening mammograms are offered annually. In the event that you require diagnostic mammography, you will be responsible for paying both a 20% copay as well as the Part B deductible.

Colonoscopy

A screening colonoscopy is performed for free once every two years for people who have a high risk of developing colorectal cancer. Medicare will fund this test every ten years if you are not at high risk.

Diabetic testing

You are qualified to receive two free checkups each year if you have a history of having high blood pressure, abnormal cholesterol levels, being obese, or excessively high blood sugar levels. If you are over the age of 65, overweight, have a family history of diabetes, or have ever had diabetes while pregnant, you are eligible to receive free diabetes testing.

Testing for prostate cancer

A PSA test is free every year. You will pay 20% of the Medicare-approved price for a digital rectal exam and the doctor’s associated fees. This also applies to the Part B deductible.

Vaccines

The cost of annual flu shots, vaccinations against pneumococcal illnesses like pneumonia, and immunizations against hepatitis B (for people at high or medium risk) is covered by insurance.

Though neither Part A nor Part B provides coverage for the shingles vaccination, your Medicare Advantage plan or Medicare Part D prescription medication plan might.

A cardiovascular condition (behavioral therapy)

Beneficiaries of Medicare are eligible for an annual free visit with their primary care physician, which can assist them in lowering the likelihood that they will acquire the cardiovascular disease.

Lung cancer examination

Free annual low-dose computed tomography (LDCT) scans are available to anyone aged 55 to 77 who has smoked for at least 30 “pack years,” shows no signs of lung cancer, and is currently smoking or has quit within the past 15 years (meaning you smoked an average of one pack a day for 30 years).

Depression assessment

Annual screening is cost-free if performed at a primary care clinic that provides follow-up care and referrals. Copayments may be necessary for subsequent medical attention.

Intensive hospital treatment

If you satisfy both of these requirements, inpatient hospital care is covered by Medicare Part A (Hospital Insurance):

  • Following a formal doctor’s order stating that you require inpatient hospital treatment to address your illness or injury, you are admitted to the hospital as an inpatient.
  • Medicare is accepted at the hospital.

When the hospital’s Utilization Review Committee accepts your stay when you are admitted, Part A may also cover inpatient care.

Free services under Medicare Part C

Medicare Advantage plans frequently have no premiums. How Medicare Advantage is free is explained here.

Does Medicare Advantage have a cost? Kind of. According to KFF, a health policy foundation, 69% of Medicare Advantage participants will be enrolled in plans with no monthly premiums in 2022. Members, therefore, pay nothing for the package.

Plans for Medicare Advantage are a bundled replacement for Original Medicare. Medicare Part A (hospital insurance), Part B (health insurance), and typically Part D are among them (prescription drugs). Additionally, they frequently provide other benefits like partial dental or vision coverage not offered by Original Medicare.

Think of Medicare Advantage plans as “bundled” since they often offer additional benefits than Original Medicare, including prescription medication coverage, vision, hearing, and dental care. Some even mention health advantages.

Inpatient care covered under Medicare Part C

Inpatient care, or being admitted to the hospital, is typically covered by Medicare Part A; however, if you choose Medicare Part C, you still receive all of Part A’s benefits, including:

  • Hospital inpatient care includes a semi-private room, standard nurse care, necessary medication, and other hospital services and supplies. This is true for inpatient psychiatric facilities, long-term care hospitals, and rehabilitation centers.
  • Semi-private rooms, food, nursing, therapy services, and other medical services are all provided as part of inpatient care in a skilled nursing facility.
  • Hospice care entails extra care and comfort measures, including equipment or drugs for pain management.
  • Home health care includes physical therapy, occupational therapy, and part-time or irregular skilled nursing care. If you need assistance leaving your home alone or if your illness requires you to remain at home, you may be eligible for home health care.
  • Inpatient or skilled nursing care is provided in a religiously affiliated non-medical healthcare facility. (However, religious products are not covered by Medicare.)

One crucial distinction to be aware of is that your out-of-pocket expenses will fluctuate depending on the type of plan.

Outpatient care covered under Medicare Part C

Outpatient treatment, which includes lab testing, X-rays, and emergency or observational services, is typically covered by Medicare Part B. Still, if you choose Medicare Part C, you’ll receive all of Part B’s benefits, including:

  • Medical visits (including primary care doctor visits and specialist visits)
  • X-rays and lab analyses
  • In case of emergency, ambulance services
  • Services for mental health
  • Sturdy medical supplies like wheelchairs and walkers
  • Preventive examinations and vaccinations, such as flu shots, heart disease, diabetes, and depression screenings
  • Physical treatment
  • Occupational treatment
  • Therapy for speech and language
  • Diabetes supplies and equipment
  • Acupuncture (up to 12 acupuncture visits in 90 days for chronic low back pain)

You can have different copayments, coinsurance, and deductibles with Medicare Part C than you would with Original Medicare.

Does Part A of Medicare provide free services?

The vast majority of Medicare Part A enrollees do not have to pay a premium.

In-patient care, including hospital stays and occasionally rehabilitation stays, is covered by this part of Medicare if a doctor determines them to be medically necessary.

Medicare.gov states that if a person satisfies the following criteria, they qualify for Medicare Part A with zero premium:

  • The person is 65 years old.
  • Either they or their partner must have worked for at least 40 quarters and paid Medicare taxes.
  • They or their spouse are either qualified for or receiving Railroad Retirement Board or Social Security retirement payments.
  • They have a handicap or some medical issues, such as end-stage renal illness, but are younger than 65.
  • A person can receive Medicare Part A without paying a monthly premium if they meet these requirements.

Some Medicare Part A plans are free, but some people may be able to pay for a portion. An individual who has paid into Medicare for 30 to 39 quarters in 2022 may be required to pay a $274 monthly Part A payment.

If a person worked fewer than 30 quarters, they might pay a $499 monthly Part A premium.

If a person qualifies for a free plan, Medicare Part A out-of-pocket expenses will apply.

These expenses for 2022 include a $1,556 deductible for each benefit period. A Medicare part A benefit period begins when an insured person is admitted to a hospital or skilled nursing facility. It expires 60 days after the patient no longer needs hospital care associated with the stay.

If a person needs another hospital admission after these 60 days, they must meet the deductible once more.

Does Part B of Medicare provide free services?

Visits to the doctor and other costs associated with them are covered by Medicare Part B, which is the section of the program. A person must pay a monthly premium if they enroll in Medicare Part B. The average premium for 2022 is $170.10

Some people may pay a more significant monthly premium depending on their income. Earners who exceed a specific threshold will pay a little bit more for Part B.

Additional out-of-pocket expenses are in addition to the premium. For 2022, Medicare Part B will have a $233 deductible and a 20% coinsurance for visits to doctors that accept Medicare.

Does Medicare Advantage have a cost?

Medicare Advantage is a plan that combines the benefits of Medicare Parts A and B with some additional assistance, including coverage for prescription medication. Occasionally, the term “Medicare Part C” will be used interchangeably with “Medicare Advantage.” Some plans additionally include coverage for dental and eye care. Commercial health insurance providers offer Medicare Advantage.

Some Medicare Advantage plans may offer free monthly premiums when someone shops around for them. Depending on the Advantage plans offered in a particular area, the actual cost will change.

One will nevertheless need to pay a fee for Medicare Part B. Additionally, people can discover that plans with free premiums have more significant out-of-pocket expenses.

Because they get funding from Medicare, private health insurance companies occasionally have the ability to provide services without charging a premium.

The insurance companies use this money to haggle prices with the doctors, hospitals, and healthcare facilities in their network. They can pass on cost savings to their plan participants as a result.

A Medicare Advantage plan does not guarantee that a person will not pay any healthcare expenses at all, just like with other components of Medicare. For particular procedures, Medicare Advantage plans frequently have specific deductibles and copayments.

Depending on the healthcare services a person typically utilizes, an Advantage plan may or may not be cost-effective.

There is usually an annual out-of-pocket expense cap for Medicare Advantage plans. This means that the plan will pay 100% of the cost of treatment until the following year once a person has spent a specific amount on deductibles or coinsurance payments.

Medicare Part D: Does it provide free services?

Prescription drug coverage is offered via Part D of Medicare. The monthly fee covers these services for Medicare Advantage members.

The cost of their prescription drugs will be covered by a monthly fee paid by people with standard Medicare policies who choose to acquire Medicare Part D from a commercial insurance provider. Depending on the drugs they use, they might incur out-of-pocket expenses.

The Kaiser Family Foundation predicts that in 2022, a prescription medication plan’s typical monthly premium will be $43. There is no set price for prescription drug programs that are managed privately.

Is Medigap (Medicare Supplemental Insurance) free?

Traditional Medicare recipients can purchase Medigap insurance to cover various supplemental services and out-of-pocket expenses that original Medicare does not cover.

The copayments, deductibles, and coinsurance fees associated with Medicare can be decreased with the help of these policies, which are not free.

Private health insurance providers provide these plans for a monthly premium.

Summary

The expense of healthcare typically rises as a person ages.

The government established Medicare to safeguard seniors, assist with cost coverage, and bargain for reasonable healthcare services on their behalf.

Medicare may be less expensive than private health plans, but several components still have monthly payments and out-of-pocket expenses.

 

Visit our website NewMedicare.com to learn more.

Related Posts

Call now to get a Free No Obligation Quote

(TTY 711)

Skip to content