MHI – Q: How can I find out if Medicare covers a particular service?

Posted by Jan
A: The Medicare & You book provides general information about services covered under Part A and Part B. That’s a good place to start. However, you may find the information is just a little more general than you’d like. What if you’re still not sure?

Go to www.medicare.gov and click on the blue box in the header “What Medicare Covers”. Fill in the name of your procedure in the “Is my test, item, or service covered?” field. Hopefully, that will provide the answer you need.

If not, I will save you a little time. Do not call 1-800-Medicare and ask them. They are not allowed to answer your question. Try talking to someone in the billing department at your doctor’s office. Chances are you’re not the first person to have that procedure done and they just may be able to share some helpful information.

If there is doubt in your doctor’s mind about whether Medicare will pay for the service, he or she may ask you to fill out an ABN. That’s short for Advance Beneficiary Notice of Non-Coverage. Your signature on this form represents your commitment to pay for the procedure if Medicare does not pay.

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