There are out-of-pockets, limitations and gaps that Medicare doesn’t cover
Medicare is a federal health insurance program for individuals aged 65 or older and certain younger people with disabilities.
And despite being a widely used program, there are several misconceptions surrounding Medicare, one of the most pervasive being that it will cover all healthcare costs.
Myth or Fact: Medicare Will Cover All Health Care Costs
Medicare is a comprehensive health insurance program that covers a range of health care services, including hospital stays, doctor visits, preventive care and prescription drugs. However, it does not cover all health care costs and there are several out-of-pocket expenses that individuals may be responsible for.
One of the most significant gaps in Medicare coverage is the lack of coverage for long-term care.
Long-term care refers to the ongoing assistance with daily activities such as eating, bathing and dressing, which is typically provided in nursing homes or assisted living facilities. Medicare will only cover a limited amount of skilled nursing care following a hospital stay and only under certain conditions.
Another area where Medicare coverage falls short is with dental, vision and hearing services. While some preventive services are covered, such as glaucoma tests and hearing exams, most routine dental, vision and hearing care is not covered by Medicare.
Furthermore, there are deductibles, copayments and coinsurance that individuals are responsible for under Medicare. These costs can add up quickly, especially for individuals who require frequent medical care.
While there are several programs available to help individuals with low incomes cover some of these costs, such as Medicaid and Medicare Savings Programs, many individuals still face significant out-of-pocket expenses.
Medicare Limitations
There are also limitations on the types of health care providers and services that are covered under Medicare. For example, individuals may be limited to seeing health care providers who accept Medicare and may not have access to all types of medical procedures or technologies.
Despite the limitations of Medicare coverage, it is still a critical program that provides essential health care services to millions of Americans.
It is also important to note that there are additional insurance options available that can help fill some of the gaps in Medicare coverage.
One option is a Medicare Supplement plan, also known as Medigap. These plans are sold by private insurance companies and can help cover some of the out-of-pocket costs associated with Medicare, such as deductibles, copayments and coinsurance.
Another option is a Medicare Advantage plan, which is an all-in-one alternative to original Medicare. These plans are also sold by private insurance companies and often include additional benefits, such as dental, vision and hearing care, that are not covered by original Medicare.
However, Medicare Advantage plans may come with certain limitations, such as a restricted network of health care providers.
Make Sure You Plan
Medicare is a critical program that provides essential health care services to millions of Americans. However, it is a myth that Medicare will cover all health care costs.
While there are insurance options available that can help fill some of these gaps, individuals should be aware of the limitations of Medicare coverage and plan accordingly to ensure they have adequate health care coverage.
Your advisor can help make sure you plan for your needs.
This information should not be construed by any client or prospective client as the rendering of personalized investment advice. For more information, visit BushWealth.com for our full disclosures.
Stacy Bush is with Bush Wealth Management.