Earlier this year, the Centers for Medicare and Medicaid Services came out with their very first phone app. The Medicare app is called What’s Covered, and it is ultimately a directory of items and services with information about whether Medicare does or doesn’t cover them.
The What’s Covered app can be helpful while you’re waiting for treatment at the doctor’s office or ER. As your doctor recommends certain services, you can quickly check the app to see if Medicare generally covers it before agreeing to have it done. The Medicare app is worth downloading if you are a Medicare beneficiary.
About the app
The Medicare app is very easy to navigate. You can either use the search bar or the directory to search for specific services and items. As you click on services, a page will come up with either a green check mark or a red “X” This indicates if Medicare generally covers it or not.
The results page will also give important information, such as costs and things to know. Keep in mind that this information is generalized. As far as what you actually pay depends on your Medicare coverage.
For example, if you search for surgery, you will see that it is covered by Medicare. You will also see that the costs depend on several factors, such as your hospital status, whether you have other coverage, whether your doctor accepts Medicare assignment, and if you have met your deductibles.
There’s also a “Things to Know” section under the “costs” section of the results page. This section includes information unique to the service and usually covers the important details to be aware of before you agree to the service.
For example, if you search for clinical laboratory tests, in the “things to know” section, you’ll see that a laboratory that meets Medicare’s requirements must provide the labs. This could mean that if you use a lab that isn’t Medicare-approved, your lab work may not be covered.
Medicare offers a handful of preventive care services, such as glaucoma screenings, vaccines, and bone density tests. Most of these preventive care services are at no cost to the beneficiary. However, for most of these services, the beneficiary must meet several requirements.
For example, to get a bone mass measurement, you must meet at least one of the following requirements:
- You’re a woman who is at risk for osteoporosis
- Your x-rays show signs of osteoporosis, osteopenia, or fractures
- You take certain steroid-type drugs
- You’re diagnosed with primary hyperparathyroidism
- You’re currently receiving osteoporosis drug therapy and are being monitored to see if it’s working
If you meet one or more of these requirements, your bone mass measurement will be covered at 100% by Medicare Part B. However, if you were at the doctor’s office and he recommended this test, without this app, you may not know if yours would be covered or not.
The Medicare app includes a complete list of all the preventive services that Medicare covers as well as their costs and descriptions. If there is a preventive service that you qualify for full coverage, the app also gives you tips on how to make sure you don’t incur unnecessary expenses. For example, if you see a doctor who doesn’t accept Medicare assignment for a fully covered preventive service, you could end up with an unexpected bill.
The shortcomings of the Medicare app
The Medicare app has a few shortcomings. However, these have been updated in the past, so they are less of a concern now. The app creators have done a fine job of fine-tuning the app to make it both useful and easy to use.
That said, a few weaknesses remain. One is the fact that you have to be pretty generalized with your searches. If you search a term that is too specific, you may not get accurate results or any results at all for that matter. For example, you can’t search for “heart transplant.” Instead, you have to search for “organ transplant.”
Another downfall is the generalized coverage information for each service. However, this isn’t the developer’s fault as Medicare coverage has to be generalized for the public since so much of Medicare coverage depends on the actual people receiving the services and their specific situations.
Other than those two downfalls, this first Medicare app has been a successful one. Download it and give it a try before your next medical appointment.