Medicare is a lifeline for millions of us. But it has some real gaps, and finding out about them after a bill arrives is no fun.
The good news is that knowing what Medicare won’t pay for puts you in the driver’s seat. You can plan ahead, set money aside, and find programs that can help fill those gaps before you ever need them.
What Medicare Leaves Out
Here are some of the most common expenses Medicare does not cover:
- Dental care — routine cleanings, fillings, and dentures are all out of pocket.
- Vision care — eye exams and glasses are not covered.
- Hearing exams and hearing aids — Medicare won’t pay for these either.
- Long-term care — if you ever need custodial care or a nursing home stay, Medicare does not cover it.
- Alternative therapies — chiropractic and acupuncture coverage depends on your specific condition and the type of treatment. Check your plan carefully.
- Cosmetic procedures — anything not considered medically necessary comes straight out of your savings.
Five Ways to Prepare
Once you know the gaps, you can start closing them. Here are five solid steps to consider.
1. Check if you qualify for Medicaid. If your income and assets are limited, Medicaid may help cover costs that Medicare won’t. It’s worth finding out if you’re eligible.
2. Look into supplemental insurance. Plans like Medigap or Medicare Advantage can help pay for copayments, deductibles, and coinsurance that Medicare leaves behind.
3. Start saving now for out-of-pocket costs. Social Security benefits alone may not stretch far enough to cover everything. The earlier you start setting money aside each month for medical expenses, the better positioned you’ll be. Even if you’re already retired, putting away what you can makes a real difference.
4. Plan ahead for long-term care. Here’s a number worth knowing: someone turning 65 today has nearly a 70% chance of needing some form of long-term care during their remaining years. Some will need only short-term help. Others, especially those with conditions like dementia, may need care for years. Long-term care insurance is one option to help cover those costs.
5. Tap into community resources. You don’t have to figure this out alone. The National Council on Aging (NCOA) offers a free online tool called BenefitsCheckUp. It screens lower-income seniors for more than 2,000 public and private benefits across the country — including Medicare assistance, SNAP, and utility aid. It can also help you enroll in the programs you qualify for.
Medicare gaps can feel overwhelming at first. But once you know what to expect, you have real options. A little planning now can save you a lot of stress (and a lot of money) down the road.