Does Medicare Cover an Advice Nurse

Steven Mott by Steven Mott | Licensed since 2012

This article was updated on: 09/10/2018

As a Medicare enrollee, you may have access to an advice nurse, depending on the type of plan you choose. Here’s what you need to know about Medicare and advice nurse services.

What is an advice nurse?

According to the U.S. Library of Medicine, an advice nurse is described as a registered nurse who is qualified and able to do phone triage and offer health advice over the phone. Triage in a health care setting means that a nurse or other health professional will assess your signs and symptoms and determine how urgently you need to be seen by a doctor or other provider.

How does Medicare cover the services of an advice nurse?

Under Original Medicare (Part A and Part B), there is no coverage specifically for the services of a telephone advice nurse. However, if your doctor or other health care provider offers those services as part of your care, any charges for an advice nurse would typically be included in your normal doctor visit charge and covered under Part B.

On the other hand, you may be able to get access to advice nurse services as part of your Medicare coverage if you are enrolled in a Medicare Advantage plan. Many Medicare Advantage managed care plans, HMOs in particular, offer these services to their members.

A Medicare Advantage plan is simply an alternative way to get your benefits under Original Medicare. They are offered by private insurance companies approved by Medicare, and by law, they must cover everything that is covered under Part A and Part B (except for hospice care, which is still covered under Part A), but they are free to offer additional benefits and perks to their members, such as coverage for routine dental and vision care, and even round-the-clock advice nurse services.

If advice nurse services or access to a healthcare nursing hotline is important to you, you may want to consider enrolling in a Medicare Advantage plan. Keep in mind that you must continue to pay your regular Part B premium, plus any additional premium required by your plan, if you choose Medicare Advantage. Not every plan may be available in every location, and premiums and benefits may vary from state to state. Be sure to read through the plan brochure carefully before you enroll to see if advice nurse services are included in your plan.

Need more information about Medicare coverage for advice nurse services?

I am happy to answer your questions; you can schedule a phone call or request an email by clicking on the buttons below. You can find out about Medicare Advantage plan options in your area by clicking the Compare Plans button.

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