top of page
  • Writer's pictureRicky Rakib

What Medicare Doesn't Cover

If you are on Medicare, you must know that Medicare doesn't cover everything. The original Medicare has limited benefits. Let's explore original Medicare.

Original Medicare includes Part A & Part B.

Part A (Hospital) helps pay for inpatient hospital stays, stays in skilled nursing facilities, surgery, hospice care, and even some home health care.

Part B (Medical) Helps pay for doctors' visits, outpatient care, some preventive services, and some medical equipment and supplies.

Now, let's explore what original Medicare (Part A & B) doesn't cover.

Prescription Medication

Original Medicare doesn't cover prescription medication. Customers can sign up for stand-alone Part D (Prescription Drug Plan) prescription drug coverage.

Long-Term Care

Contrary to popular belief, Medicare doesn't cover long-term care. Every day at least a few senior clients ask me this question. In 2017, the median cost of a private room in a nursing home was nearly $97,500. Customers can sign up for Long-Term Care insurance; however, if you didn't purchase a Long-Term Care policy when you were younger, they can be costly. An alternative, less expensive solution is to obtain annuities or whole life policies with Long-Term Care riders.

Co-Pays and Deductibles

2021-Part A, the deductible is $1,484 (before your benefits start). If you get hospitalized for more than 60 days, starting 61 days -90 days, your co-pay per day is $371, days 90 and beyond your co-pay is $742 per day.

2021-Part B, the deductible is $203 and 20% co-insurance.

So, you can see how fast the bills can add up with the original Medicare option.

Most folks will purchase either a Medicare Supplement Plan (Medigap) + Part D Plan or go on Medicare Advantage Plan (Part C). if you qualify for both Medicare and state Medicaid, they take care of most expenses.

Dental, Vision Care, & Hearing

Most dental & routine vision check-up is not covered original Medicare. Most Medicare Advantage Plans (Part C) offer basic dental, vision, and hearing coverage.

Medical Coverage Overseas

Medicare usually doesn't cover care you receive while traveling outside of the U.S., except for minimal circumstances (such as on a cruise ship within six hours of a U.S. port). Some Medigap plans offer overseas coverage. If you are going to travel overseas, it's a good idea to purchase travel medical insurance. They are very inexpensive and can be a lifesaver.

So, if you are on Medicare, you should choose the right option to cover your original Medicare gaps. There is no best solution. Each case is different, and based on your situation, your options to supplement original Medicare will change. If you have any questions, contact me directly

Ricky Rakib

Principal: HealthCare Affairs

(720) 744-0065

23 views0 comments
bottom of page