5 things not covered by Medicare
Medicare doesn’t cover everything
It’s important to understand that Medicare doesn’t cover everything once you are eligible. I know it would be easier if it did. But there are gaps in coverage. Some of these gaps are small. Others leave large holes that you are responsible for.
There are 5 main gaps that people are unaware of when first starting Original Medicare.
Prescription Medications – Original Medicare does not cover prescription medications. For this reason it’s critical to add drug coverage if you do not have it through another source. You can do that by purchasing a stand alone prescription drug plan or a Medicare Advantage plan that includes prescription coverage.
Long Term Care – Many people aren’t certain what long term care is. It’s really not medical care but more like assistance with every day tasks. Things like eating, dressing, bathing, or moving from a bed to a chair.
Often times this kind of care occurs in nursing homes. It can also by very expensive. National averages are almost $7,000 a month for a shared room. That’s over $80,000 a year! Like I said, it’s expensive. And Medicare does not cover any of it.
Vision – Do you have glasses? Or maybe contacts? No coverage for either of those. If you see the eye doctor for routine visits that will not be covered by Medicare either. Medicare does not include vision coverage.
Medicare Advantage plans may include some additional coverage. I wouldn’t recommend purchasing an Advantage plan solely because it includes vision benefits. But if you like the plan already then it would be a nice bonus.
Otherwise stand alone plans are always available as well. Depending on your unique situation they may or may not be good value for you.
Dental – You should see the dentist every 6 months for teeth cleaning. This is a recommendation for your health. Original Medicare forces you to cover the costs for those cleanings by yourself. And if you need any work done then that’s your responsibility too.
Well again a Medicare Advantage plan may include some additional benefits for dental. Otherwise a stand alone plan could be helpful to reduce some of your expenses.
Foreign Travel – Medicare covers you while in the United States. There are a few exceptions but in general you should plan on having other coverage if you travel or live outside of the United States.
Concerned about these gaps?
Many clients I work with are concerned about what’s not covered by Medicare. We can work together and make sure your risk is limited. Call me at 608-571-4461 for help.
Mike Lovell