Making sure Medicare isn’t a mystery to you is important to us at Jeffery Insurance. This includes helping you understand the limitations of your Medicare coverage. Here’s a closer look at six things that original Medicare doesn’t cover.
Dental Care
Medicare doesn’t cover routine dental visits, teeth cleanings, fillings, dentures, or most tooth extractions. It will only cover medically necessary dental services. An example of this would be dental surgery for treating oral cancer. Some Medicare Advantage plans cover basic cleanings and X-rays, but they generally have an annual coverage cap of $1500. If you want to stick with original Medicare, then you should look into getting a separate dental insurance plan, or build up money in a health savings account before you enroll in Medicare.
By age 55, more than 80% of people wear eyeglasses or corrective contact lenses.
Eye Care
By age 55, more than 80% of people wear eyeglasses or corrective contact lenses. However, Medicare doesn’t cover eye care, which includes eye exams, glasses, or contacts. Exceptions include surgery and a single pair of eyeglasses if you’re diagnosed with cataracts, and an annual eye exam if you have diabetes. Routine eye care is generally available with Medicare Advantage plans as a supplemental coverage (which includes a monthly premium) or an included benefit. If you don’t want Medicare Advantage, you can set aside money in a health savings account or look into discount eye exam options at big-box stores like Wal-Mart, Sam’s Club, or Costco.
Hearing Aids
Roughly one-third of seniors 65 and over are affected by disabling hearing loss. Medicare doesn’t cover routine hearing exams or hearing aids, which can cost as much as $3,250 per ear. If you have Medicare Advantage, it may pay for at least part of the cost of a hearing aid. If it doesn’t, or you have original Medicare, consider buying insurance or a membership in a discount plan that helps cover the cost of such hearing devices.
Overseas Care
As things begin to open back up around the U.S. and the world, you might be itching to travel. But be aware that you won’t have health coverage with original Medicare when outside the country (yes, even for emergencies). However, there are a few exceptions you should be aware of. If you’re traveling between Alaska and the lower 48 and you need emergency care while passing through Canada, Medicare may cover the treatment. Medicare will also cover you if you are on a cruise ship within six hours of a U.S. port. If you want to be protected while you travel abroad, look into a travel health insurance policy. These plans cover everything, including evacuations and transportations in case of emergencies.
Long-Term Care
Long-term care is one of the largest potential expenses in retirement, but Medicare, like most health insurance plans, generally doesn’t cover it. This includes nursing homes, adult day-care services, and home healthcare. According to the Genworth Cost of Care Study, the median cost of a private room in a nursing home in 2020 was roughly $105,800. A room in an assisted-living facility cost $51,600, and 44 hours per week of care from a home health aide cost $54,900. To help with the costs, you can buy long-term-care insurance or get a combination long-term-care and life insurance policy.
With original Medicare, you’re still responsible for deductibles and co-payments.
Deductible and Copays
Medicare Part A covers hospital stays and Medicare part B covers doctor services and outpatient care. However, you’re responsible for deductibles and co-payments. In 2021, you’ll have to pay a Part A deductible of $1,484 before coverage kicks in, and you’ll have to pay a portion of the cost of long hospital stays. Part B typically covers 80% of doctor services, lab tests, and X-rays, but you’ll have to pay 20% of the costs after a $203 deductible.
Jeffery Insurance Agency
It’s important to be aware of all the things Medicare doesn’t cover so there are no surprises down the line. At Jeffery Insurance, we are always here to help you understand Medicare and answer any questions you have about its coverage and your plan. We are based in Scottsdale but are happy to assist you no matter where you are in Arizona. We are Arizona’s health care resource!
