When signing up for Original Medicare, it’s important to know what’s covered and what’s missing. Here’s all you need to know about what’s missing in your Original Medicare plan.
What is Original Medicare?
Original Medicare includes Medicare Part A and Part B. Part A is for hospital insurance, and it helps to cover inpatient hospital and skilled nursing facility stays, home health care, and hospice care. Part B is for medical insurance that covers doctor visit bills, outpatient care, durable medical equipment, and some preventative services.
What’s Missing
Unfortunately, Original Medicare doesn’t cover quite a few things you may need to keep you healthy in your golden years. The following service it doesn’t cover include:
- Prescription drugs
- Long-term care
- Deductibles and copays
- Chiropractic care
- Medical care for feet
- Hearing aids
- Routine vision care
- Routine dental care
- Overseas care
It should be noted that Part B does cover outpatient drugs in certain circumstances. These drugs are typically administered at a doctor’s office or hospital outpatient setting and are usually only for a short period of time. For long-term prescription drugs, you’ll need a Part D drug plan.
Be Mindful of Long-Term Care
Long-term care is one of the big things Original Medicare does not cover. According to the Department of Health and Human Services, a person turning 65 today has about a 7 in 10 chance of needing long-term care at some point in the future. And unfortunately, extended nursing home stays, assisted living facility stays, and custodial care isn’t covered.
It can get confusing because Medicare does cover nursing services, but only if your doctor recommends it after a qualifying three-day inpatient hospital stay. In these circumstances, Medicare will cover the first 100 days of care along with a daily coinsurance charge. After that, you’re responsible for all costs.
Don’t Forget Vision and Hearing
Eyeglasses, contact lenses, and hearing aids all aren’t covered by Original Medicare. Exams to check hearing, vision, and choose and fit hearing aids and corrective eyewear aren’t covered either unless a doctor conducts an exam in an emergency to determine if a patient needs urgent medical treatment. Medicare Part B does cover one pair of glasses or contacts if you have cataract surgery. And even then, after the Part B deductible of $233 in 2022, you’ll pay 20% of the costs. Otherwise, the care of your vision and hearing is left to you.
Keep Your Teeth in Check
Although Medicare Part A covers some dental services you may get as a part of a hospital stay, basic dental care like cleanings, X-rays, fillings, dentures, and tooth extractions aren’t covered.
What’s the reason behind it not being covered by Medicare? Simply put, for a long time, dental work wasn’t considered important enough to be covered by Medicare due to a lack of information and resources. Even though dentistry is now an accepted practice, the coverage of dental care through Medicare isn’t a certainty yet. It can seem like an easy thing to skip getting coverage for, but oral hygiene is vital to one’s overall health and well-being. Routine preventative visits with your dentist can help catch many serious diseases and conditions early on. Even better, a recent Cigna study about dental costs found that on average, those who receive consistent preventative dental care can reduce their total medical bills by 4.4% each year.
How Do I Get Coverage for What’s Missing?
Knowing what’s missing from your Original Medicare is important to know what your plan offers and to help you plan ahead. But it can also feel a little frustrating. All these things aren’t covered – so now what?
Thankfully, there are a few options you can choose to get coverage for the missing items you need. A Medicare Advantage plan can cover quite a few things. A Medicare Advantage plan covers Part A, Part B, and can include Part D prescription drug coverage, vision, and dental. Not all Medicare Advantage plans include dental, so it’s best to check the plan details before enrolling.
A separate insurance plan can also help. Medicare does not frown upon getting other insurance plans outside of them, so you can get one that covers long-term care, vision, and hearing. Finding a dental plan will help keep dental costs down and maintain your oral health. There are lots of plans out there, but Jeffery Insurance can help you find the right plan through Delta Dental. Our professional team can help you find a plan that offers dental while keeping your other providers, all while making it accessible to have routine dental care and procedures to keep your smile healthy.
Let Jeffery Insurance Lend a Hand
Whether you’re looking for the right Medicare Advantage plan or Delta Dental plan, Jeffery Insurance will be there to lend a hand. Our team is always here to help you understand Medicare and answer any questions you have about its coverage and your plan. We are based in Scottsdale but are happy to assist you no matter where you are in Arizona. We are Arizona’s health care resource!
