Know Your Benefits: The Key Ancillary Services Medicare Covers

ancillary services medicare

Your medical care is comprised of many moving parts, and some aren’t even technically considered medical treatment. They’re actually seen as add-ons called ancillary services. Insurance like Medicare is built to provide healthcare treatment, but sometimes understanding your coverage can be tricky, especially when dealing with these associated resources.

For example, say your friend falls and breaks her wrist. She has an initial visit with a doctor who treats her injury. But she also may have an ambulance ride to the hospital, wound care services to prevent infection, a series of x-rays and an inpatient or outpatient rehabilitation program. She might even be provided with personal care assistant services, if her injury inhibits her ability to take care of herself.

When you consider her entire experience, the actual visit to the doctor is just one small part of the treatment your friend needs to heal her broken wrist. And, if those services aren’t covered, the costs add up quickly!

What are ancillary services? 

Ancillary services actually cover a very broad range of treatments and resources. Basically, if a service isn’t performed by your primary care provider (PCP), it’s probably ancillary. As anyone who has ever needed therapy, x-rays, or even lab tests knows–many services fall into this category. 

The list of common ancillary services many seniors need to stay healthy or recover from an injury includes:

  • dental,
  • vision,
  • hearing,
  • ambulance transport,
  • rehabilitation,
  • transitional care, 
  • personal assistance services,
  • behavioral health,
  • hospice care,
  • lab tests, and
  • radiology.

Of course, this list isn’t exhaustive. But it should give you an idea of the wide range of benefits available. So, how do you know if your Medicare plan covers all these ancillary services? 

Medicare’s ancillary coverage options 

Medicare Part A and Part B cover services provided by your PCP and/or hospital staff. For example, if an ear exam is part of your regular checkup with your PCP, you’re covered by Medicare. 

Now, if you need to go beyond what your PCP or hospital staff provide (like a trip to the dentist or an eye doctor appointment), Original Medicare won’t cover it. For example, long-term care is typically covered by Original Medicare, while short-term care often goes through ancillary insurance. 

How Medicare plan-holders can get ancillary service coverage

Of course, some Medicare Advantage plans do cover ancillary services. If you qualify for Medicare Advantage, you might be able to get these benefits as part of your regular insurance package. 

If Medicare Advantage is not right for you, there are still options for ancillary service coverage through a private provider. Your Medicare insurance agent should be able to help connect you with some of these options. So keep in mind that ancillary insurance plans offer year-round enrollment, unlike Medicare, and services are billed separately from your existing Medicare coverage. 

Ancillary coverage allows you to mix and match the most important benefits for your specific needs. Yes, finding one plan to cover everything is great. But when the coverage isn’t right for you, having access to multiple plans gives you more freedom to create the ideal benefits package. 

How can I get ancillary coverage? 

Knowing you have the necessary coverage for both everyday life and medical emergencies is invaluable. If you’re already enrolled in a Medicare plan, talk to your insurance agent about options for add-on coverage or switching to Medicare Advantage in the next enrollment period. For those considering enrolling in Medicare, ask about ancillary service coverage when choosing your plan. 

For any questions about your plan options or benefits, get in touch with us at 877.255.6273.


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