How Can I Pay For What Medicare Doesn’t Cover?


Many new beneficiaries often think that Medicare alone is enough to cover all their health care expenses, only to find out later that they are wrong. If you find yourself asking, how can I pay for what Medicare doesn’t cover?, then you are on the right track in Medicare planning.


What are the things that Medicare does not cover?


Avoid unwanted healthcare costs surprises by knowing what Medicare does not cover. That way, you will be able to prepare yourself and know the options you can use to pay for them. Here are the things that Medicare do not cover:

  1. Prescription drugs

Medicare does not cover outpatient prescription drugs.

You can: Buy a separate Prescription drug coverage, also known as Medicare Part D. You can enroll in a prescription drug policy once you sign up to Medicare. You can also change your policy annually during the Medicare open enrollment period, so make sure to review it every time.


  1. Long term care.

All of us are at risk of needing long term care at any point in retirement. This one also involves staggering expenses which unfortunately are not covered by Medicare. Though Medicare covers some skilled nursing services, it does not include custodial care (assistance with bathing, dressing and other activities of daily living).

You can: Do a long term care planning and buy yourself a long term care insurance. You can also consider Medicaid. But Medicaid requires certain financial requirements that must first meet.


  1. Deductibles, Copays or Coinsurance

Medicare Part A and Part B cover your hospital and outpatient medical needs. But the take away here is that you are responsible to pay for paying deductibles and copayments. For the year 2018, you need to pay first the deductible of $1,340 before coverage starts. And you still part in paying for your daily hospital stays, that would be $335 per day on your 61st to 90th day in the hospital and will be higher for the days after that (about $670 per day). Once you use up all the days covered by Medicare, you will be left all alone to pay the full hospital costs.

Wait there’s more! You still have your part of the payment for Medicare part B! Medicare Part B only covers only up to 80% of doctors services, lab tests, x-rays etc. Meaning you need to pay for the remaining 20% of each cost of the procedures that you have to undergo. You also need to meet first the required deductible of the year ($183 for 2018).

You can: Enroll in a Medicare Supplement plan.

Depending on the type of plan you’ll get, it will pay all or part of the expenses not covered by Medicare mentioned above. That will provide a lot of relief on your financial shoulder.

Medicare Supplements also called as Medigap, are sold by private insurance companies. It has ten standardized plans that you can compare and choose from. If you have pre-existing conditions, be sure to grab the guaranteed issue rights during your open enrollment period.


  1. Most dental care

Unfortunately, Medicare does not cover dental visits, teeth cleanings, fillings, dentures or tooth extractions.


You can: Enroll in Medicare Advantage plans.

Some Advantage plans include basic dental services but have a cap of $1500. You can also buy separate dental insurance for more comprehensive dental services coverage.


  1. Vision care

Routine eye exams and glasses are not covered by Medicare.


You can: Enroll in certain Medicare Advantage plans that provide vision coverage or another insurance plan with vision coverage.


  1. Medical care Abroad

If you are someone who frequently travels overseas, you should know that Medicare doesn’t usually cover for the medical services you need outside the US.

You can:

Buy a Medicare supplement plan with travel coverage. Medigap plans, C, D, F, G, M and N all have Foreign Travel exchange coverage.



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