Medicare provides health coverage to millions of seniors today. But even with that coverage, retirees commonly have to reach into their wallets to cover expenses that Medicare won’t pay for. Here are a few items that fall into that category.
1. Dental care
Medicare doesn’t cover dental care. If you’re a Medicare enrollee and need a cleaning, expect to pay out of pocket.
That said, in some cases, dental care could relate to a medical procedure that Medicare has approved. In that situation, you may have associated dental care covered by the program.
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2. Eye exams and eyeglasses
Medicare will pay to treat things like eye injuries and certain health issues that impact the eye. But it won’t pay for you to get your vision checked to see what prescription you need. It also won’t pay for you to get a new pair of eyeglasses if your prescription changes.
3. Hearing aids
Medicare won’t pay for hearing aids or screenings. As an enrollee, you’re on your own.
4. Medical care abroad
The nice thing about Medicare is that you can generally receive care in just about any part of the U.S. Once you go abroad, though, it’s a different story. If you expect to travel a lot, make sure to buy insurance that will pick up the tab for medical issues that arise overseas.
5. Long-term care
Medicare will only pay for services that are medical in nature. Long-term care often falls under the umbrella of custodial care — meaning, help with everyday living. Since that’s not a medical issue, Medicare won’t cover it.
6. Most chiropractic care
Medicare will pay for manual manipulation of the spine to cover specific approved medical conditions. But it won’t pay for general chiropractic care. This extends to services like massage therapy.
You may have options for getting some of these services covered
Original Medicare won’t pay for the services listed above, but you may find that a Medicare Advantage plan will pick up the tab for most of these items. Medicare Advantage is an alternative to original Medicare. When you sign up for an Advantage plan, you’re basically getting coverage through a private insurer, but your plan must provide at least the same level of coverage as original Medicare.
For some people, Medicare Advantage makes sense because of the additional services it covers. And there are other perks, as well. One is that Medicare Advantage plans put a limit on annual out-of-pocket spending for enrollees, but original Medicare doesn’t.
But one thing you should know about Medicare Advantage is that you may be limited to a small network of providers and pharmacies. That could make it difficult to get the care and medications you need. So before you rush to sign up for Medicare Advantage, consider that drawback.
Also, you may end up finding that Medicare Advantage is more expensive than original Medicare, especially if you have a lot of health issues. So it’s important to do your research before making your choice.
If you opt to stick with original Medicare, plan to set aside extra money to cover the above costs. While you’re at it, sign up for supplemental insurance, which won’t cover services Medicare doesn’t but will generally help with deductibles and copays.
To cover long-term care, you might need to set aside a lot of money. And you may want to look at long-term care insurance if you don’t have a policy already. But all told, you may find that original Medicare is your most cost-effective option, even though it doesn’t cover the above-mentioned services.