There’s a lot to think about when you’re choosing a
Medicare plan. And it’s important your plan provides
access to the care and benefits you need, to take
care of the whole you. Did you know there are four
parts to Medicare — A, B, C, and D? Original Medi care
includes Part A and Part B, which includes a
lot, but not everything. That’s where Medicare Part
C (Medicare Advantage plans) or Medicare Supplement
plans (also known as Medigap) come in.
Like Original Medicare, Medicare Advantage plans
combine Parts A and B. Some Medicare Advantage
plans also offer prescription drug coverage (Part D).
Unlike Original Medicare, Medicare Advantage plans
might also include other benefits at no added cost,
like hearing aids or eye care, fitness memberships,
wellness services, or a nurse phone line. Before you
shop for a Medicare plan, do your research to find out
what’s covered and what’s not. It can help you save
time and money. Here’s a closer look at what Original
Medicare might not cover:
1. Long-term custodial (non-medical) care Longterm
care, which includes nursing home care, home
health aides, and more, is one of the largest potential
expenses in retirement. On average, the cost of
a private nursing home is $97,000 a year, while an
assisted living facility costs $45,000, according to a
2017 Genworth study. Original Medicare doesn’t cover
long-term non-medical care (often called custodial
care). Long-term custodial care isn’t covered by most
health insurance plans, but may be covered under
Medicaid. You can also choose to buy private longterm
care insurance.
2. Prescription drugs Medicare Part B (medical insurance)
only covers some prescription medicines.
Medicines that aren’t covered under Part B may be
covered under Medicare Part D, which can be purchased
separately by a private insurer. Medicare Advantage
plans, which include Part A and Part B, may
also include Part D. Before you make any changes,
check your plan’s formulary — the list of medicines
the plan covers — to see if your medicines are cov ered.
3. Deductibles, copays and coinsurance Medicare
Part A covers things like hospital stays, hospice care,
and home health care. Part B covers medically necessary
doctors’ services, outpatient care, durable
medical equipment, and more. You’re still responsible
for deductibles and copayments or coinsurance.
4. Some dental care Original Medicare doesn’t
cover routine dental visits, teeth cleanings, fillings,
dentures, or most tooth extractions. Some Medicare
Advantage plans offer dental coverage, or you can
buy dental insurance separately.
5. Hearing aids Original Medicare doesn’t cover
hearing exams, hearing aids, or exams for fitting
hearing aids. Check with your health insurer, as some
Medicare Advantage plans cover hearing aids and fitting
exams, and also provide discount programs and
savings on hearing aids.
6. Routine vision care Original Medicare covers
annual eye exams if you have diabetes or another
chronic condition, or if you require eyeglasses after
having certain kinds of cataract surgery. However,
many routine eye exams or new eyeglasses aren’t
covered. Check with your plan, or look into a Medicare
Advantage plan if you need more comprehensive
vision benefits.
You have options Medicare can be overwhelming,
but you have options. Whether you’re looking at
Original Medicare, Medicare Advantage or Medicare
Supplement plans, it’s important you take the time to
research to ensure you’re getting the health care and
coverage you need.
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