Medicare HMO (Health Maintenance Organization) plans and Medicare PPO (Preferred Provider Organization) plans differ mainly in the rules each has about using the plan’s provider network. In general, Medicare PPOs give plan members more leeway to see providers outside the network than Medicare HMOs do.
Medicare covers a device called an ambulatory blood pressure monitor for use once a year when ordered by a doctor. It does not cover regular “cuff” blood pressure monitors except for people undergoing dialysis at home.
You may file an appeal if you disagree with a coverage or payment decision made by Medicare or by your Medicare health or prescription drug plan. You may appeal if you receive a denial any of the following:
Medicare Part B generally covers a screening blood test for cholesterol once every five years. You pay nothing for the test if your doctor accepts Medicare assignment and takes Medicare’s payment as payment in full.
Original Medicare (Parts A & B) may cover medically necessary care on a cruise ship, if the ship you’re on when you receive the care is in U.S. waters. That means the ship needs to be within six hours of a U.S. port. Also, the doctor must be legally allowed to provide medical services on a cruise ship.
Medicare defines “creditable coverage” as coverage that is at least as good as what Medicare provides. Therefore, creditable drug coverage is as good or better than Medicare Part D.
Medicare Advantage plans and Medicare supplement insurance plans can both help Medicare beneficiaries get coverage above and beyond what’s offered by Original Medicare (Parts A & B). But each plan works differently and serves a different purpose. It’s important not to confuse them.