When it comes to health insurance for seniors, Original Medicare is a popular choice. Millions of Americans select it every year. It offers coverage for many essential health services. There are some gaps in coverage for Original Medicare that you need to be aware of.
Here are five key things that Original Medicare does not cover and some examples to help illustrate these gaps.
1. Routine Dental Care
Dental Care is one of the top requested needs. This can surprise many who planned on relying only on Medicare alone for their health insurance needs. Original Medicare does not cover routine dental care, including cleanings, gum scrapings, crowns, fillings, and dentures. Suzie has several different Dental Plans to fill in the gap.
Example:
Imagine you’re 70-year-old retiree, Mrs. Johnson. You notice some discomfort in your mouth after eating some Quincy Corn and decide to visit your dentist. After the exam, the dentist tells you a filling fell out and the pain is from a root canal you need. This painful surprise is out of pocket because Original Medicare doesn’t cover dental.
2. Vision Care
Original Medicare covers eye exams for people with diabetes and annual glaucoma tests for high-risk patients. It does not cover routine eye exams or hardware like glasses or contact lenses. Are you sensing a trend for medical coverage from the shoulders up?
Example:
Mr. Thompson, an 68-year-old retired teacher, starts having trouble reading the Wenatchee World. He schedules an eye exam at the Vision Center at Confluence and discovers he needs an updated prescription. Mr Thompson is paying out of pocket for the exam and glasses because these are not covered by original Medicare.
3. Hearing Aids and Exams
Hearing loss is common among seniors, but Original Medicare does not cover hearing aids or the exams needed to fit them.
4. Long-Term Care
Original Medicare does cover skilled nursing facility care, but only for a limited time and under specific conditions. It doesn’t cover custodial care, which includes help with daily activities like bathing, dressing, and eating if that’s the only care you need.
Example:
Imagine you are Mrs. Rivera, 82, and living alone while your kids are living in Montana. After a fall, you find it difficult to manage daily tasks like bathing and dressing. You need long-term care to help with these activities. Unfortunately, Original Medicare does not cover this type of care. This expense is going to add up quickly.
5. Overseas Health Care
Original Medicare generally does not cover health care when you travel outside the United States. This can be a significant concern for those who love to travel or have family abroad. We had to start using a travel insurance exchange to provide options.
Example:
Mr. and Mrs. Davis, a retired couple, decide to take a dream safari to Africa. While abroad, Mrs. Davis falls ill and needs medical treatment. Since Original Medicare doesn’t cover international medical care, they face hefty medical bills, adding stress to what should have been a relaxing trip.
Getting Help with Coverage Gaps
Navigating the complexities of Medicare and understanding what it does and does not cover can be overwhelming. This is where Suzie with Wenatchee Insurance comes in. Suzie helps clients understand their Medicare options and then finds solutions to cover the gaps left by Original Medicare.
Suzie can help you explore Medicare Advantage plans, which often include additional benefits. These plans might also provide some coverage for long-term care and overseas health care. Additionally, Suzie can guide you through supplemental insurance options, known as Medigap policies, which can help cover some of the out-of-pocket costs not covered by Original Medicare.
Conclusion
Don’t let coverage gaps surprise you reach out and have a chat with Suzie today and ensure you have comprehensive health coverage for all stages of life. While Original Medicare provides valuable coverage, it’s crucial to be aware that it has limitations.
Routine dental care, vision care, hearing aids, long-term care, and overseas travel health care are significant areas where coverage gaps can occur.
By understanding these gaps and seeking assistance from professionals like Suzie at Wenatchee Insurance, you can find the right coverages to meet your needs.
Topics: Medicare, Original Medicare, Medicare Advantage, travel insurance, Cashmere, Wenatchee Insurance, Suzie, Enrollment, Glasses, Contacts, Chelan County, Okanogan, Grant County, Douglas County, 509, Leavenworth
