Far too many seniors sign up for Medicare thinking that it will cover everything they need. Unfortunately, this is not the case. Medicare Part A and Part B are a good starting point, but not the kind of comprehensive insurance most people think it is.

What Medicare Does not Cover

Medicare does not cover the following:

  • Long-term care, such as time spent in a nursing home or memory care unit.
  • Dentures and most dental care.
  • Eye exams for prescribing glasses (as opposed to treating medical conditions)
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and hearing exams 
  • Routine foot care
  • Medical care when out of the United States.

Drug coverage is also a separate coverage, called Part D, which you need to sign up for (and pay for) separately. Additionally, Medicare has deductibles and coinsurance. Thankfully, there are options to help you avoid paying out of pocket for services Medicare does not cover.

What Are Your Options?

There are several things you should consider to ensure that the gaps in Medicare coverage are handled:

  • Long-term care insurance will protect your assets and your family if you end up having to go into a nursing home for an extended period of time or permanently. You may also be able to get insurance that will cover the cost of a home aide.
  • Medicare Supplement Insurance, also known as Medigap, covers things like deductibles and coinsurance. You can also get Medigap insurance that includes medical care when you travel outside the U.S. This can be a little more expensive, so consider it only if you are likely to need it.
  • Medicare Advantage. This is when you sign up for a plan with a private health company that contracts with Medicare. These plans are sometimes called Part C, are covered by Medicare rules, but may also have their own rules. Most of these plans include prescription drug plans, and you are not able to get separate Part D if you are in a Medicare Advantage HMO or PPO. Look for a policy which also covers vision, hearing, and dental.

Can you Keep your Doctor?

One question many people ask when they sign up for Medicare is whether or not they can keep their doctor. Some doctors take Medicare patients, and some do not. A Medicare Advantage plan that includes your doctor in their network may allow you to keep your doctor even if a standard Medicare plan does not. This is something you should explore with your insurance agent before signing up.

Aren’t HMOs Bad?

Some Medicare Advantage plans are HMOs. HMOs have a bit of a tricky reputation, but it’s not entirely justified. Typically, the only downside of a Medicare Advantage HMO is the limited provider network. If your doctor is already in that network, then you are golden. HMO plans also tend to be your cheapest option and will offer the best preventive medicine options to keep you healthy as you age.

If you’re about to turn 65, it’s time to start doing research about your Medicare options. By doing your research in advance, with the help of a professional, you’ll be able to find the best insurance options to keep you covered. 

LEAVE A REPLY

Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.