5 Things Medicare Does Not Cover (and how to get coverage)

Medicare does not cover

Do you ever feel like deciphering Medicare coverage is like trying to solve a Rubik’s Cube blindfolded? As a personal finance expert, I can tell you that understanding what Medicare does not cover and does cover is crucial to avoid unexpected medical bills. In this article, we’ll unravel the mystery of five things Medicare doesn’t cover, and how to find solutions to get them covered. Ready to dive in?

What Medicare Covers

Traditional Medicare consists of Parts A and B, which cover most medically necessary services. But wait, there’s more! Medicare supplement plans, or “Medigap,” can help with cost-sharing for these services. However, it’s essential to know that some things still fall through the cracks.

Five Things Medicare Does Not Cover

Routine Eye Examinations, Glasses, and Contact Lenses

Surprisingly, Medicare covers cataract surgery and glaucoma treatment, but it turns a blind eye to routine eye examinations, glasses, and contact lenses. What’s the solution? Medicare Advantage plans or vision insurance policies can help you see the light, covering these costs.

Hearing Tests and Hearing Aids

Can you hear me now? Medicare covers ear-related medical conditions but doesn’t lend an ear to routine hearing tests or hearing aids. Don’t fret! Medicare Advantage plans, discount plans, or over-the-counter options can help you tune into these costs.

Dental Services

When it comes to dental exams or dental work, Medicare leaves you with a toothache. No coverage here! But don’t lose your smile just yet. Medicare Advantage plans or standalone dental plans can help with these costs. Dental discount plans and combo plans are other options worth considering.

Full Routine Annual Physical Examinations

Medicare covers a Medicare wellness exam but not a full routine physical examination. Confusing, right? There may be out-of-pocket costs for a full physical exam. Make sure to discuss with your healthcare provider the difference between the two exams to avoid surprises.

Long-Term Nursing Care

Medicare covers a limited stay in a skilled nursing facility, but when it comes to long-term care or custodial care, you’re on your own. Planning for nursing care is essential. Options include saving, purchasing long-term care insurance, or relying on Medicaid.

Getting Coverage for Things Medicare Does Not Cover

To cover the gaps, consider supplemental insurance plans or alternative options, such as discount plans or over-the-counter options. Understanding the different types of plans available, such as Medicare Advantage and Medicare supplement plans, can help you choose the best plan for your individual needs. Feeling overwhelmed? Financial advisors or independent brokers can come to the rescue, assisting with these decisions.

The Bottom Line

By now, you should have a clearer understanding of what Medicare does not cover and what it does, and the need for solutions to get coverage for what’s not covered. Remember, resources like financial advisors and independent brokers are available to help you navigate the Medicare maze. So don’t stress – with the right knowledge and a bit of planning, you’ll be able to tackle Medicare like a pro!

Resources

To help you navigate the world of Medicare coverage and supplemental plans, I’ve compiled a list of resources for you to explore:

  1. Medicare.gov – The official U.S. government site for Medicare provides comprehensive information on coverage, plans, and costs.
  2. State Health Insurance Assistance Programs (SHIPs) – SHIPs offer free, unbiased, one-on-one counseling and assistance for people with Medicare and their families.
  3. Eldercare Locator – A public service of the U.S. Administration on Aging, Eldercare Locator connects you to services for older adults and their families, including help with understanding Medicare coverage.
  4. National Council on Aging (NCOA) – The NCOA provides tools and resources for older adults, including Medicare and Medicaid information, to help them make informed decisions about their healthcare.
  5. AARP – AARP offers a wealth of resources on Medicare, including articles, videos, and an interactive Medicare Q&A tool.

Remember to consult with a financial advisor or independent broker for personalized advice and guidance when making decisions about Medicare coverage and supplemental plans. These professionals have the expertise to help you choose the best options based on your individual needs and circumstances.

By leveraging these resources and seeking expert assistance, you’ll be well-equipped to make informed decisions about your healthcare coverage and ensure you’re prepared for whatever life throws your way. So, go ahead and take control of your Medicare journey with confidence, knowing that you’ve got the information and support you need to make the best choices for yourself and your loved ones.