New Medical Technology*
Posted on March 2, 2016
It seems that every day brings news of new medical tests, devices and treatments. You may wonder if a particular treatment or item is a covered benefit with your Health New England Medicare Advantage plan. As new technology is made available, Medicare decides which medical services and products will be covered, subject to Medicare laws and regulations.
Medicare covers only those treatments that are determined to be safe and effective, medically necessary and not experimental. As a Medicare health plan, Health New England Medicare Advantage must cover all services covered by Original Medicare’s coverage rules. Our Medicare Advantage plan follows National Coverage Determinations (NCDs), the Medicare Benefit Policy Manual and Local Coverage Determinations (LCDs) to make coverage determinations for our Medicare Advantage members. If you have questions about whether a particular test, device or treatment is covered, call Member Services.
Medicare may cover your medical services when you are in an approved “clinical research study.” A clinical research study is a way that doctors and scientists test new types of medical care, like how well a new cancer drug works. They test new medical care procedures or drugs by asking for volunteers to help with the study. This kind of study is one of the final stages of research process that helps doctors and scientists see if a new approach works and if it is safe. Not all clinical research studies are open to members of our plan. Medicare first needs to approve the research study. For more information, contact Member Services or see your plan Evidence of Coverage.
If you have questions, you may call Member Services at (413) 787-0010 or (877) 443-3314. For TTY/TDD, call (800) 439-2370. A representative is available Monday through Friday, 8 a.m. – 8 p.m.
H8578_2016_490 Accepted
*Health New England Medicare Advantage is an HMO Plan with a Medicare contract. Enrollment in Health New England Medicare Advantage depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copays and restrictions may apply. Benefits, premiums and/or copays/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.
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