What Medicare Doesn’t Cover
Medicare does not cover everything, which is why at Bourgeois Insurance, we strive to help reduce the surprise Medical bills that might arise. To learn more about the enhanced Medicare benefits we offer, do not hesitate to reach out at (985) 803-8999 . We will help you find the plans that perfectly fit your lifestyle.
The Original Medicare program (Part A & Part B) covers most Medicare expenses, but it still can leave large gaps behind. It is important that you are aware of these potential holes, but that you know that you can receive added benefits just by working with our agency.
We are always happy to help any client learn how to perfect their Medicare benefits. Consider just a few of the ways that you might not get the right coverage, and what you can do about it.
1. Long Term Care
Medicare can cover hospital care, but it will only cover extremely limited costs for long-term care.
However, the cost of continuing wellness care can be astronomical for Americans in retirement. Nursing homes can cost more than $100,000 per year and a room in an assisted living facility can cost more than $50,000 a year. Home health care services can cost more than $45,000 a year. Medicare will not cover custodial care such as help with bathing, dressing and other activities of daily living.
Skilled Nursing Care Original Medicare Pays (2021)
Days 1–20: $0 for each benefit period .
Days 21–100: $176 coinsurance per day of each benefit period.
Days 101 and beyond: all costs.
You can clearly see based on the numbers above that you will only receive long-term care coverage in limited circumstances. However, you can reduce your own cost burden by investing in a Medicare plan option that offers further long-term care benefits. Bourgeois Insurance offers multiple plan options that can help you find the right solutions at affordable costs.
2. Prescription Drugs (Part D)
To get prescription drug benefits through Medicare, you must enroll either in a Medicare Part D plan or a Medicare Advantage plan. Both are private plan options offered through Bourgeois Insurance. Unless you enroll in either plan, you might have no prescription coverage.
Most Medicare Advantage plans include Part D coverage, so you will not have to buy both Advantage and Part D plans separately. However, always review your Part D coverage during your Annual Enrollment Period each fall or if you have a special enrollment opportunity. Many of the plans change from year to year and your coverage needs may change. Not making sure you are getting everything from your Part D coverage can be very costly.
Please note: If you have a Medigap/Medicare Supplement Plan you will need to enroll in a Part D plan since they are not included in the policy.
Even though Original Medicare Parts A & B will cover extensive costs, they will require you to pay out of pocket, as well.
Adding a Medicare Supplement Plan or Medicare Advantage plan can dramatically help cover these costs. However, please remember that both plans will also limitations to what they will cover, and they might not make your medical bills equal $0.
Bourgeois Insurance Agency can help you understand where these gaps might exist, navigate them, and find plans that will help reduce your expenses. You might also have the choice of adding hospital indemnity plans or critical care plans which can reduce your exposure as well.
4. Vision, Dental and Hearing Aids
Original Medicare generally does not cover routine vision care, dental care or hearing aid services. However, they might cover medically necessary eye exams for diabetes or cataract surgery.
Many Medicare Advantage plans do include this in their plans, which is one of the main reasons they are so attractive to most Medicare recipients. However, Medicare Supplements/Medigap Plans do not.
Additionally, many people can still buy a stand-alone policy that may include dental, hearing and/or vision benefits. Bourgeois Insurance offers a large choice of companies that can offer these policies.
5. Medicare Overseas
In most cases Medicare does not cover care you receive while outside the US. The only exceptions might be medical care you receive on a cruise ship that is within 6 hours of a U.S. port.
Medicare Supplements and Medicare Advantage plans might offer this coverage. However, there will often be limitations to these benefits as well. A better solution might be a travel insurance policy that covers medical expenses.
Bourgeois Insurance offers a comprehensive travel insurance program. Simply call us or click HERE to customize the policy you prefer.
To Get the Right Coverage, Use an Independent Agency
Working with an independent Medicare agency like Bourgeois has no added cost to you. We are Medicare experts, and we offer numerous Medicare plan enhancements provided by multiple major insurance carriers.
By working with us, you will receive expert guidance on what different Medicare plans will do for you and have a choice of countless policies available in your local area. We are here to make sure that you do not get stuck in a plan you do not really need, pay too much for your coverage, or face penalties because you forgot to enroll in a plan during your qualifying enrollment periods.