Does Medicare Cover Osteoarthritis?

There are dozens of different types of degenerative joint diseases which most people know as arthritis. The most common type of arthritis is Osteoarthritis. It happens when the cartilage cushioning a joint wears out resulting in bone grinding against bone. This painful condition causes stiffness in the joints, usually accompanied by swelling. It can result in joint replacement surgery.

So, it is important to know how Medicare covers Osteoarthritis.

Original Medicare (Part A & Part B) will cover medically necessary services and supplies for osteoarthritis treatment:

  • Part A of Medicare helps cover you for hospitalization, rehabilitation, skilled nursing care, and home health care.
  • Part B of Medicare helps cover you for doctors’ services, outpatient care, durable medical equipment (like wheelchairs, crutches, etc.) and preventive services and medications (injections) given in the doctor’s office.

If you are enrolled in Original Medicare only, Prescription Drugs for pain relief are not usually covered at all.

Remember, though, as I’ve mentioned before in my articles, ‘covered for’ does not necessarily mean completely paid for. When a service or treatment is covered under Original Medicare there is an entire host of costs or portions of costs that you are responsible for after Medicare pays their share. These include the Part A Deductible (e.g. if you are in the hospital for joint replacement) and Co-insurance. It also includes the Part B Deductible (doctor’s services, etc.), the 20% Part B Co-insurances and excess charges.

As the costs to you can really add up for Osteoarthritis, I advise all Medicare beneficiaries that I meet to enroll in a Medicare Supplement Reno plan as well as a Prescription Drug Plan. If affordable, these provide the best supplemental coverages available, in my opinion.

Or, it may be that an MA-PD (Medicare Advantage Reno Plan with Prescription Drug Coverage) is right for you. You can enroll every year during MA-PD plan Open Enrollment (October 15th through December for January 1st coverage). As you age, you should review the benefits of your MA-PD every year. Doing this may help you find a plan that better meets your changing needs. You should also pay close attention to the prescriptions you take regularly for relief from arthritis pain.

The professionals at Health Benefits Associates are a great source of information and help hundreds of Medicare Beneficiaries annually select and maintain the plans that best fits their needs. In addition, we do not charge you any fees to be your health insurance broker.