Exemptions to the Individual Mandate
There are some cases where there is no penalty to not having coverage.
The following services are provided under Medicare. Medicare supplement plans help pay for portions of these services not covered by Medicare. The following details, from www.Medicare.gov, will help you determine whether or not you will need a supplement policy.
A semiprivate room
Other hospital services and supplies
This includes care in critical access hospitals and inpatient mental health care.
Private duty nursing
A television or telephone in your room
It does not include a private room (unless it a private room is medically necessary)
Medicare does not cover Part A deductible, coinsurance, or coverage after your allotted number of days have been used each benefit period.
A semiprivate room
And other services and supplies (after a related 3-day hospital stay).
You must have been admitted to the Medicare-approved nursing facility within 30 days of leaving the hospital.
Medicare does not cover coinsurance or coverage after 100 days per benefit period.
Medicare covers pints of blood you get at a hospital or skilled nursing facility during a covered stay after the first three pints.
Medicare does not cover the cost of the first three pints of blood. You are responsible for the cost of the first three pints and the Part B deductible.
Medical and support services from a Medicare-approved hospice for people with a terminal illness
Drugs for symptom control and pain relief
Hospice care is given in your home.
However, short-term hospital and inpatient respite care (care given to a hospice patient by another caregiver so that the usual caregiver can rest) are covered when needed.
You must have a doctor’s certification of a terminal illness.
Medicare does not cover the copayment or coinsurance.
Outpatient medical and surgical services and supplies
Ambulatory surgery center facility fees for approved procedures
Durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers)
Second surgical opinions
Outpatient mental health care
Outpatient physical and occupational therapy
Including speech-language therapy
Medicare does not cover the Part B deductible or coinsurance.
And other tests for diagnostic services.
Part-time skilled nursing care
Home health aide services
Medical social services
Durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers) and medical supplies
And other services
Medicare does not cover the Part B deductible.
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