2. Hearing aids
Medicare covers ear-related medical conditions, but original Medicare and Medigap plans don’t pay for routine hearing tests or hearing aids.
Solution: If you are in a Medicare Advantage plan, check your policy to see if it covers hearing-related needs. If it doesn’t, or if you have original Medicare, consider buying insurance or a membership in a discount plan that helps cover the cost of such hearing devices. Also, some programs help people with lower incomes to get needed hearing support. Or you can pay as you go. Congress passed legislation in 2017 that allows some hearing aids to be sold over the counter without a prescription. The Food and Drug Administration has until August to issue proposed guidelines for the sale of these devices.
3. Dental work
Original Medicare and Medigap policies do not cover dental care such as routine checkups or big-ticket items, including dentures and root canals.
Solution: Some Medicare Advantage plans offer dental coverage. If yours does not, or if you opt for original Medicare, consider buying an individual dental insurance plan or a dental discount plan.
4. Overseas care
Original Medicare and most Medicare Advantage plans offer virtually no coverage for medical costs incurred outside the U.S.
Solution: Some Medigap policies cover certain overseas medical costs. If you travel frequently, you might want such an option. In addition, some travel insurance policies provide basic health care coverage — so check the fine print. Finally, consider medical evacuation (aka medevac) insurance for your adventures abroad. It’s a low-cost policy that will transport you to a nearby medical facility or back home to the U.S. in case of emergency.
It’s still known as alternative medicine, but services like chiropractic care, acupuncture and therapeutic massage are not that alternative anymore. According to the National Center for Complementary and Integrative Health, almost 40% of adults and 12% of children use complementary or alternative medicine, or CAM, to stay healthy and treat chronic or severe conditions.
Many more would likely use some kind of complementary or alternative treatment if it were covered by their insurance company. While many carriers cover a few services under certain circumstances, most CAM treatments are not covered, forcing patients to pay for it out of their own pocket.
Data from a 2016 study led by the NCCIH suggest that Americans are more and more willing to pay those out-of-pocket charges. Between 2002 and 2012, those who saw a chiropractor rose from 7.5% to 8.3%. The numbers were 1.1% to 1.5% for acupuncture and 5% to 6.9% for massage. Interestingly, usage rates stayed the same for those who had at least some insurance covering the care, but they went up among those who lacked coverage.
For those looking to have complementary or alternative treatments covered, here is what you should know.
CAM Coverage Varies
The NCCIH says that Americans spend about $30.2 billion each year out-of-pocket on complementary health products and practices beyond what their insurance covers. This includes:
- $14.7 billion for visits to such practitioners as chiropractors, acupuncturists and massage therapists.
- $12.8 billion on natural products.
- About $2.7 billion on self-care approaches, including homeopathic medicines and self-help materials, such as books or CDs, related to complementary health topics.
The 2016 study found that 60% of the respondents who had chiropractic care had at least some insurance coverage for it in 2012, but those rates were much lower for acupuncture (25%) and massage (15%). Partial insurance coverage was more common than complete coverage. For chiropractic, nearly 40% of respondents had no coverage, 41.4% had partial and 18.7% had complete coverage. For acupuncture, the breakdown was 75%, 16.5% and 8.55%, and for massage, it was 84.7%, 8.35% and 7%.
The NCCIH says the following complementary or alternative treatments are most often covered to some degree:
- Chiropractic: 91% of big insurance companies cover prescribed chiropractic care, most limited to between 15 to 25 prescribed visits with a $20 to $30 copay.
- Acupuncture: 32% of big insurance firms cover acupuncture, usually limited to about 20 visits annually.
- Massage: Roughly 17% of large insurance firms cover massage therapy, typically if physical therapy and medication hasn’t helped.
- Homeopathy: Only 11% of major insurers cover homeopathic remedies.
- Hypnosis: Insurers that cover hypnosis require physician authorization, and they typically cover only 50% to 70% of costs.
- Biofeedback: Only a few insurers cover the mind-body technique biofeedback, and when they do it’s only for a documented condition like migraines or fibromyalgia.
- Naturopathy: Insurers are more likely to cover a licensed naturopath, but only 19 states have such licensure.
Those are averages, of course, and some plans cover a lot more than others. The Capital