Identifying Medicare Coverage Gaps

Identifying Medicare Coverage Gaps

Approximately 61 million, or 18% of the population is currently enrolled in Medicare, so if you are feeling intimidated looking at your sign-up options you are not alone. A lot of retirees feel overwhelmed when they start to browse the Medicare literature, and unfortunately, many more feel just as confused when open enrollment rolls around. Trying to figure out the answer to “What does original Medicare not cover?” can be confusing.

Medicare coverage gaps can cost you thousands if you are caught off-guard by a medical emergency, which is why it is vital that you choose your health insurance plan carefully. However, the literature does not exclusively outline where the Medicare coverage gaps lay. Instead, most Medicare guides cover what is covered and leave retirees to ascertain what is missing. Unless you happen to be a healthcare expert or case manager, you probably don’t have enough background knowledge to spot the Medicare coverage gaps, but that is where Just Us comes in.

We have identified the top Medicare coverage gaps so that you know exactly how to protect yourself from unexpected health bills in the future. Here is a handy list of everything that basic Medicare does not cover so you know exactly what you need to add-on if you choose to purchase an Advantage Plan or Medigap insurance.

Prescription Drugs

Basic Medicare Part A and Part B do not cover prescription drugs, but prescription drug coverage is required of everyone on Medicare. It can be added on in the form of Part D or applicants can choose a Medicare Advantage Plan that includes prescription drugs. However, it is vital to remember that basic Medicare does not cover prescription drugs and that adding it on later will incur a penalty.

Deductibles & Co-Pays

While Medicare Part A covers any hospital stays and Part D covers doctors’ appointments this does not include your co-pays and/or deductible. For instance, basic Medicare does not cover your deductible for an inpatient stay and in 2021 the deductible will be $1,484. If you are not prepared for this additional expense it can drain your financials quickly, especially for seniors on a fixed budget. A Medigap plan can help fill the Medicare coverage gap and is a good idea for seniors who don’t have savings to fall back on.

Dental Care

One of the big obstacles for seniors who discover the answer to “What does Medicare Not Cover” is dental care. Basic Medicare does not cover any type of dental including teeth cleanings, dentures, fillings and tooth extractions (that are not a medical emergency). If you are concerned about your dental health and the affordability of dental care it may be prudent to research A Medicare Advantage Plan that does include x-rays and basic cleanings. However, be aware that even these dental plans usually have a coverage gap of around $1,500 similar to employer-sponsored dental plans.

Get Help Choosing a Medicare Plan

These are some of the largest Medicare coverage gaps, but there are others that may catch you depending on your health needs. Vision, hearing aids and long-term care are just a few of the many other things original Medicare does not cover. It can be extremely useful to hire an insurance agency that is skilled at navigating insurance plans to help you find affordable health care premiums that are still affordable if you get sick. Contact Just Us for more information on a Medicare plan that truly covers your needs.

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