How to Cover what Medicare Doesn’t

For people over 65, Medicare covers many hospital and medical expenses. However, Medicare Part A and Part B don’t cover everything, and sometimes, it’s not completely clear what is considered an out-of-pocket charge. Some of the most necessary health services for those over 65 aren’t covered with traditional Medicare, so it’s important to understand your options. Thankfully, the experienced advisors at Senior Financial Group are available to navigate you through the Medicare system. They will review all the different options available to you and get you the medical coverage you need at an affordable cost.

Medicare Part A covers inpatient hospital care, some stays in a nursing facility, surgery, hospice, lab tests and some home health care. Medicare Part B covers regular doctors’ visits, outpatient procedures, and some medical equipment and preventative services. Unfortunately, medical services and medications that don’t fall into these categories are left up to you to pay out-of-pocket.

Here’s a list of the top 7 items not covered by Original Medicare.

1. Prescription Drugs

Prescription drugs are a necessity when dealing with certain medical conditions and illnesses, but Original Medicare doesn’t cover the costs for outpatient prescriptions which can sometimes be overwhelmingly high. However, by signing up for a Medicare Part D or a Medicare Advantage Plan, the cost of your medications can be significantly reduced and in some cases be 100% covered.

2. Long-Term Care

While Medicare covers skilled nursing services that can be beneficial to someone in need of weekly injections or physical therapy, it doesn’t cover most home health care or assisted-living care that help with activities of daily living like bathing, dressing and eating. An expert advisor at SFG can help you find the long-term-care insurance that’s right for you or a loved one’s needs.  In most cases you’ll pay less if you buy a long-term insurance policy at age 50 versus waiting until you’re closer to retirement.

3. Deductibles and Co-Pays

Both Medicare Part A and Part B cover your doctor’s visits and services, but they don’t cover your deductibles and co-payments. These costs can really add up, especially if doctor’s visits become a weekly or monthly routine. Thankfully, a Medigap policy or Medicare Advantage plan can help to cover these costs, but it can be tricky to figure out what plan works best for your situation, so we recommend discussing the options with an experienced Medicare advisor.

4. Dental Care

Your dental health is key in your overall health. Medicare doesn’t cover regular dental check-ups and procedures, so additional coverage would need to be purchased to cover the costs. Your options include a Medicare Advantage Plan (some MA plans cover routine dental) or you can look to a dental insurance policy to provide support and coverage.

5. Vision Care

Medicare covers annual eye exams for those with diabetes and those who have had certain types of cataract surgery, but it doesn’t cover routine eye exams, glasses or additional services. Some Medicare Advantage Plans can assist with coverage, and there is also the option of a vision insurance supplement.

6. Hearing Health

Hearing screenings and hearing aids aren’t covered by Medicare and can be very costly. Some Medicare Advantage plans include hearing health, while other supplemental and discount programs can help cover some of the costs.

7. Overseas Medical Care

When traveling internationally, anything can happen, including a medical emergency. Medicare typically doesn’t cover any care you receive that’s outside of American soil, but with some Medigap plans, a large percentage of the costs can be covered. If you travel internationally, we suggest reviewing all the Medigap plans that provide foreign travel emergency health care coverage with a trusted advisor. There’s also the option of purchasing additional travel insurance that could help to cover medical expenses.

When you enroll in Medicare Part A and/or Part B, you can no longer contribute pre-tax dollars to your HSA.  However, if you have an existing HSA, you can use it tax-free for many of the qualified services listed, as long as you still have a balance in your account.

Medicare offers great coverage for most medical and hospital services, but it’s important to know how to fill in the gaps so you don’t have a lot of unexpected, out-of-pocket expenses. Senior Financial Group advisors strive to equip you with the information and resources needed to make an educated decision about your Medicare coverage.

Senior Financial Group does Medicare differently.

Download our FREE
Medicare 101 Guide

Download our exclusive 20-page guide that covers Medicare from all angles, from coverage types to financing options & more!

Download the 2024 Medicare Guidebook

New to Medicare or need a quick refresh? Download our free 2024 Medicare guide to get everything you need to know.