Top 5 Health Care Costs Covered By Medicare – The Motley Fool

Medicare is one of the largest government programs in the United States, and the vast majority of Americans aged 65 and over rely on Medicare to help them meet their health care needs . The program is vital to the financial security of older Americans, especially because health costs typically increase with age, reaching hundreds of thousands of dollars over the years of a typical person's retirement.

Medicare coverage has many benefits, from hospital stays to doctor's visits to other medical needs. But Medicare does not claim to cover everything, and even if you have Medicare, you still need to be willing to pay a portion of your health care costs. Below, we will examine five key areas in which Medicare will not cover all of your health needs.

1. Long-term care

One of the most important and important areas that Medicare does not address is that of long-term care. Although you can receive care in a qualified nursing facility for up to 100 days, this solution is primarily designed to meet rehabilitation needs after a visit to the covered hospital. What most people consider as nursing home care, in which staff are available to handle non-medical needs and tasks of daily living, are not covered by Medicare.

Even if you benefit from a Medicare supplemental insurance policy, also called Medigap coverage, you will still not receive benefits for long term care needs. Instead, you will need long term care insurance if you want to be protected against these costs.

2. Ordinary dental care

Dental coverage is also something that Medicare leaves out. You will not receive benefits for routine cleanings, dental exams, fillings, dentures and other ordinary dental care. Part A hospital insurance covers only a small number of emergency or complex dental procedures.

Unlike long-term care, some complementary Medicare policies offer dental coverage as an added benefit. Similarly, some private insurers offer dental coverage through Medicare Advantage. Otherwise, you will have to cover your own dental expenses or purchase private dental insurance that will go with your traditional Medicare coverage.

3. Vision Care

Medicare does not cover routine eye exams for glasses or contact lenses. There are some exceptions for corrective lenses that follow more complex procedures such as cataract surgery, but in most cases you will have to pay for the corrective glasses in your pocket.

As with dental care, some insurers offer vision care benefits. You may be able to obtain coverage through additional Medicare or Medicare Advantage policies.

4. Part of your hospitalization expenses

The Medicare Part A hospitalization insurance comprehensively covers the vast majority of the costs associated with hospital care, including hospital stays and specialist nurse visits. But that does not cover every penny. Patients are responsible for covering a deductible for each benefit period, which for 2019 is $ 1,364. That's the only thing you have to pay for a stay up to 60 days, but beyond that, you'll also be responsible for a $ 341 per day co-insurance payment for days 61 to 90 and $ 682 per day. day for up to 60 days of life reserve if your stay exceeds 90 days. For extremely long stays at the hospital, Medicare does not cover anything beyond 90 days once you have used your 60 day reserve.

Medigap coverage often helps pay for deductibles and co-insurance payments, but it's harder to get extra protection for long hospital stays. Similarly, the insurer of a Medicare Advantage plan often incorporates the costs of deductibles and co-insurance into their premiums.

5. Part of your medical expenses

Part B of the health insurance covers doctor visits and most outpatient services, but for most services it covers only 80% of the cost. You are usually responsible for the other 20%. In addition, a deductible of $ 185 applies for 2019. These fees do not apply to the annual Medicare visit on welfare. However, if your doctor requests additional tests or provides additional services during this visit, the standard deductible and 20% co-insurance may apply.

One of the best features of complementary insurance and Medicare Advantage is that they often include these costs in their coverage. Your 20% share being potentially unlimited, additional protection is valuable.

Be smart with Medicare

Medicare is a valuable program that can save you thousands of dollars in health care costs in retirement. By knowing its limitations, you will be able to take full advantage of the benefits offered by Medicare while making informed decisions to determine if you need additional coverage through a Medicare supplemental policy, Medicare Advantage or a private insurance provider.