NEW services for 2025 and beyond! (And 7 Surprising Benefits COVERED by Medicare!)

Did you know that Medicare will cover bariatric surgery?

Yes, it’s true. There are many surprising things that Medicare covers including benefits that are new for 2025 and beyond.

New Benefits

Expanded mental health services.

Not only can you now see a marriage and family therapist but also CMS has addressed a coverage gap in mental and behavioral health services. Many people fall between the need for outpatient and inpatient mental health care and Medicare will now cover more intensive outpatient services to bridge that gap. 

Part D Changes

There are huge changes coming to Part D. The two biggest changes are the introduction of negotiated prices and the elimination of catastrophic coverage.

Negotiated Prices- first for the first time ever the federal government and Medicare are able to negotiate the prices for the 10 most expensive prescription drugs. This is so important because it is estimated that 1 in 7 cannot afford their prescriptions. Many people have to skip doses of life-saving medications.

Catastrophic Coverage- Part D plans have eliminated the donut hole and will move directly to a lower threshold catastrophic coverage phase. In years past you had a 25% coinsurance in the donut hole followed by a 5% coinsurance during catastrophic coverage. Although steps had been taken to remediate that, last year the threshold to meet catastrophic was still 8K. In 2025, it will drop all the way to 2K and that is extremely significant.

Surprising Benefits

There are also many benefits offered by Medicare that may surprise you.

1. Bariatric Surgery can be covered by Medicare. Gastric surgery or laparoscopic banding can be covered and this was certainly not always the case. 
2. Hearing is not covered by Original Care. And this is mostly true. Original Medicare will not cover hearing aids. However, your doctor may be able to order a hearing exam once per year if they consider if medically necessary.
3. Similarly, Original Medicare does not cover vision. And again, this is mostly true (your basic reading glasses will not covered). However, Medicare will of course cover an annual glaucoma screening once every 12 months if you’re at high risk. Additionally, they will cover one pair of standard frame glasses from a Medicare approved supplier if you have an approved cataract removal surgery during which an intraocular lens is implanted.
4. Medicare also does cover some foot care and podiatry services under certain circumstances. 
   1. Diabetes related foot problems
   2. Lower nerve damage in your legs
   3. Risk of limb loss
   4. Hammer toe or bunion deformity
   5. Heels spurs 
5. Chiropractic care and acupuncture may be covered. Although chiropractic care and acupuncture for general wellness are not covered, sublation to manipulate the spine or acupuncture for acute lower back pain can be!
6. Tobacco cessation counseling is also available. Medicare will provide services to help you quit smoking. You actually get up to 8 face to face visits in a 12 month period. 
7. Coverage outside of the US can also be offered. You can actually get additional foreign travel exchange benefits with Medicare Supplement Plans, but Original Medicare actually covers benefits not only in the continental US and of course Alaska and Hawaii but also Puerto Rico, American Samoa, and the US Virgin Islands.