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I need to see my doctor for a specific test. How can I find out if Medicare will cover it or not?

Medicare has very strict rules about what it covers, and does not cover. That said, there are many places where you can find general information about your Medicare benefits. Here are some ways to find out:

  • Check out the Medicare & You handbook: This handbook is mailed to people with Medicare every year, usually in September. It gives you a broad overview of what Medicare covers and provides. You can also find this handbook online at Medicare’s website.
  • Use Medicare’s online coverage search tool:
    • Go to Medicare’s homepage
    • Enter the test, service, or item you wish to search
    • Select your state
    • From this list you will see if Medicare covers it, and how much they will cover
  • If you have Original Medicare (Medicare Parts A and/or B), call Medicare at 1-800-633-4227.
  • If you get your Medicare through a private Medicare Advantage health plan such as an HMO or a PPO, call your Medicare plan directly.
  • You may also wish to speak with your doctor; many doctors have experience billing Medicare and will know what will be covered.

If you still have questions, you can get personal help in your area.

Topic: Coverage of services and supplies, Premiums and costs

Keywords: coverage, tests

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