Common Medical Conditions And How Medicare Covers Them

May 15, 2023

As we age, it’s not uncommon for us to experience medical conditions or illnesses. The good news is that Medicare, a federally funded health insurance program, covers a wide range of medical conditions and treatments. However, it’s essential to understand what Medicare covers and the benefits it provides. In this blog post, we’ll explore the medical conditions and illnesses covered by Medicare and how it can assist individuals in obtaining necessary medical care.

Understanding Medicare Coverage

Coverage for Medical Conditions

Medicare covers a range of medical conditions, including chronic and acute conditions, hospitalization, doctor visits, preventative care, prescription drugs, rehabilitation, home health care, hospice care, and mental health. Chronic conditions are medical conditions that persist for an extended period or requires ongoing medical attention. Examples include diabetes, heart disease, cancer, arthritis, Alzheimer’s Disease, Parkinson’s, Multiple Sclerosis, Chronic Obstructive Pulmonary Disease (COPD), and kidney disease.

Acute conditions, on the other hand, are short-term medical conditions that require immediate medical attention, such as a heart attack, stroke, or lyme disease. Medicare assists with hospitalization due to both chronic and acute medical conditions, providing coverage for medically necessary hospital stays. Individuals with chronic conditions can often receive ongoing medical care outside of the hospital setting, such as doctor visits and physical therapy.

To qualify for Medicare, one needs to be at least 65 years old, or have specific disabilities or chronic medical conditions. During the Initial Enrollment Period (IEP), which starts three months before a person’s 65th birthday and concludes three months after that, one can join Medicare. Individuals who fail to join during the IEP can join during the General Enrollment Period, which are between January 1st and March 31st of each year.

What Medical Conditions Does Medicare Cover?

Common Medical Conditions Covered by Medicare

Below are some of the most typical medical conditions that Medicare covers, such as chronic diseases, mental health, neurological, respiratory, vision and hearing impairments, and a lot more.

Diabetes

Medical conditions such as diabetes and obesity affect a significant portion of the American population aged 65 and above, with over 26% affected by diabetes alone, as reported by the Centers for Disease Control and Prevention (CDC). Thanks to Medicare, beneficiaries can receive coverage for a range of diabetes-related services, including insulin pumps, diabetic eye exams, therapeutic shoes, and blood glucose monitors accompanied by test strips.

Heart Disease

Heart disease tops the charts of medical conditions as the leading causes of death among seniors residing in the United States. To ensure the provision of necessary medical services, Medicare provides an array of healthcare benefits. This includes coverage for cardiac rehabilitation, coronary angioplasty, and implantable cardioverter-defibrillators (ICDs), among other chronic conditions that require doctor visits.

Cancer

Chronic illnesses and diseases are a significant threat to seniors. Fortunately, Medicare provides comprehensive health insurance coverage, which includes cancer treatments such as chemotherapy, radiation therapy and surgery. Medicare also covers doctor visits and preventive services like mammograms and colonoscopies for pre-existing conditions such as cancer.

Mental Health Conditions

Mental health issues, which include depression, anxiety, bipolar disorder, and schizophrenia, are prevalent among seniors in the US. Health insurance providers such as Medicare offer coverage options for various mental health services, including outpatient therapy, inpatient psychiatric hospitalization, and prescription drugs for mental health ailments.

Neurological Conditions

Dementia and Parkinson’s are some common neurological conditions among seniors in the United States. Health insurances like Medicare provide a host of services for treating these conditions, such as occupational therapy, physical therapy, and speech therapy. In addition, conditions like Autism and Down Syndrome may also be covered by Medicare.

Vision and Hearing Impairments

As we get older, we may experience a decrease in our vision and hearing abilities. Fortunately, Medicare offers health insurance coverage to address a multitude of vision and hearing impairments. Included in this coverage are comprehensive eye exams, eyeglasses, hearing aids, and even speech therapy. Medicare policies also cater to health issues such as cataracts and glaucoma to ensure the best quality of life.

Respiratory Conditions

Health conditions affecting the respiratory system like Chronic Obstructive Pulmonary Disease (COPD) and asthma are widespread among seniors in the US. To cater to patients suffering from these diseases, Medicare provides coverage for inhalation therapy, nebulizers, and oxygen therapy, as part of their health insurance program.

Medicare Coverage for Preventative Care

Preventative Care

One of the essential features of Medicare coverage is preventative care. Medicare covers several preventative care services, including cancer screenings, flu shots, and cardiovascular disease screenings. Preventative care measures are crucial for maintaining good health outcomes. It’s vital for individuals to take advantage of this benefit as it can potentially save your life.

Medicare Part B provides coverage for yearly wellness visits that comprise an overview of the medical history, a physical examination, and a medication analysis. Additionally, Medicare funds preventative screenings such as mammograms, colonoscopies, and bone density scans. Finally, immunizations are also covered by Medicare, including vaccines for flu and pneumococcal.

Medicare Coverage for Prescription Drugs

Prescription Drugs

Prescription drugs are a significant aspect of medical care, particularly for those with chronic medical conditions. Medicare offers prescription drug coverage known as Part D. Part D consists of a list of drugs that are covered by Medicare. The list of drugs is known as a formulary. Part D benefits assist those who need different prescription drugs levels to pay for medication costs.

Cost of Medicare and KanCare

Co-Pays, Deductibles, and Pre-existing Conditions

Medicare also offers coverage for co-pays and deductibles, although individuals may still need to pay a small amount out of pocket. For instance, in the case of prescription drug coverage, there may be an annual deductible. More serious medical conditions may also come with a co-pay or out-of-pocket expense. In addition, those with pre-existing conditions can still obtain coverage through Medicare.

Medicare Coverage for Hospitalization

Hospitalizations

Hospitalization can be expensive, with medical procedures and recovery costs. The good news is that Medicare covers most hospitalizations without incurring unexpected bills. Medicare provides coverage for room and board, medical supplies, therapies, and rehab upon hospital discharge.

Medicare Coverage for Home Health Care

Home Health Care, Rehabilitation, and Hospice Care

Medicare also covers home healthcare services, including healthcare staff coming to the individual’s place of residence, managing medication, assessing function, and providing wound care. Rehabilitation services such as speech therapy, physical therapy, and occupational therapy also fall under the services that Medicare covers. Hospice care is another benefit of Medicare and provides medical care, pain management, and emotional support to those in their last stages of life.

Medicare Coverage for Home Health Care

Mental Health and Substance Abuse

Medicare provides coverage for mental health care and substance abuse treatment, both inpatient and outpatient, including therapy, psychiatrist visits, necessary mental health medications, and the treatment of substance abuse.

Importance of Medicare

Conclusion

In summary, Medicare offers a comprehensive range of benefits, medical services and treatments for individuals ailing with a spectrum of medical conditions, chronic or acute. Through its various forms, Medicare provides ample medical services, including preventative and mental healthcare services as well. It’s crucial for individuals to understand their coverage so that they can receive the care they need without facing unexpected out-of-pocket expenses or inadequate insurance coverage. With Medicare, individuals with chronic and acute medical conditions can get the care and support they need to attain a better quality of life. Make the most of the coverage and necessary medical care available to you under Medicare today.

Find a Medicare Clinic Near Me

Medicare Clinic in Wichita, Kansas

HealthCore Clinic is located in Wichita, Kansas, and offers comprehensive care to Medicare patients. Our integrated approach to care is particularly beneficial for Medicare patients. With our team-based methodology, patients have a more active role in enhancing their health. Our responsive prevention services include evidence-based initiatives that provide access to state-of-the-art medical advances. As well, we are able to reduce the number of visits required since we have medical, dental, behavioral health, labs, and a pharmacy all under one roof.

See why Medicare patients in Wichita continuously choose to come to HealthCore Clinic for all of their healthcare needs. Call 316-691-0249 or click below to schedule an appointment today!

DISCLAIMER: The information contained in this article serves purely informative purposes and cannot be taken as medical advice. Please seek the advice of a healthcare professional if you have any queries or concerns about your medical condition or Medicare coverage.