Two of my neighbors told my wife that they get free gym membership through Medicare.
Any truth to that, as I never heard about this before?
John Houston, TX
John, the answer is NO! Medicare Parts A and B do not provide a gym membership for those who are enrolled in Medicare. It would be logical if they did because exercise does keep you healthy.
On page 59 of the 2018 Medicare & You handbook under “What’s NOT Covered by Part A & Part B?” It states… “Original Medicare does not cover everything and if you need certain services that Medicare doesn’t cover, you will have to pay for them yourself unless you have other insurance to cover the costs.”
The Medicare & You handbook also states…
■ You have other coverage (including Medicaid) to cover the costs.
■ You’re in a Medicare Advantage Plan that covers these services.
Some of the items and services that Original Medicare doesn’t cover include:
✘ Most dental care.
✘ Eye examinations related to prescribing glasses.
✘ Cosmetic surgery.
✘ Hearing aids and exams for fitting them.
✘ Long-term care. See page 60 for more information about paying for long-term care.
✘ Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care).
John, an extra benefit that helps to enhance Medicare Advantage Part C plans is that when one enrolls they are offered Silver Sneakers which provides a gym benefit. The Toni Says ® Medicare team always advises those new to Medicare or changing their Medicare plan to discuss if their primary care doctor or specialists are in that plans network. Recently, a few Medicare Supplement plans may also have “extra gym membership benefits”.
Since Medicare doesn’t cover dental, I would recommend that you talk to your dentist and see which dental insurance plan he/she prefers.
There are 2 different types of dental plans:
- Traditional or indemnity dental insurance plans which is generally higher in premium and the preventive services are usually covered at 100%, basic restorative is generally covered up to 80% and major procedures at 50%. Many of the traditional/indemnity dental plans may have a wait for services such as fillings, root canals, bridges, crowns, etc.
- Discount dental plans are generally less expensive than traditional dental plans. These plans provide a discount for services, but your dentist must be part of the plan and agree to give the dental discount.
On page 45 of the Medicare handbook, it talks about eyeglasses (after cataract surgery) which is a limited benefit because Medicare will cover one pair of eyeglasses with standard frames (or one set of contact lenses) after cataract surgery that implants an intraocular lens. The Medicare Part B deductible will apply for the cataract surgery and you will pay the 20% of the Medicare-approved amount.
Medicare defines glasses as an elective. Do not understand why vision is considered elective (not covered), since we do need to see to drive, but it is.
Hearing aids are also considered elective, just like glasses. “Medicare covers the exams if your doctor or other health care provider orders them to see if you need medical treatment. You pay the 20% of the Medicare-approved amount and the Part B deductible applies.”
You can see that you cannot compare Medicare with the “extra” benefits that you are accustom to. Most companies will allow you can keep your dental/vision benefits when you retire. Always ask your HR.