In the United States, every day around 10,000 people celebrate their 65th birthday, and they also become eligible for Medicare. For years they pay payroll taxes at work to help fund this government program. Now it is their turn to sign up for Medicare and have health insurance for the rest of their lives.
Many new Medicare enrollees are surprised to find that basic Medicare plan does not cover a variety of health-care expenses, and this hit them pretty hard. It is because most people think that Medicare covers everything, including dental, vision, and hearing. Whereas, in reality, dental, vision, and hearing costs are not covered under Medicare.
Medicare Part A
Medicare Part A of Original Medicare provides coverage for hospital stays, skilled nursing care, hospice care, and some home health services. People having 10-year work history do not require to pay for their Part A coverage, though it comes with a deductible of $1,408 per benefit period along with annual caps on benefits.
Medicare Part B
Part B coverage starts when beneficiaries pay a visit to a doctor or receive outpatient services like a flu shot. This part of Original Medicare also covers medical equipment or devices like blood-sugar monitors or crutches.
Medicare Does Not Provide Following Coverages:
Original Medicare does not cover prescription drugs. Although, beneficiaries have the option of getting prescription drug coverage when they first sign up for Medicare. Seniors who don’t enroll for prescription drug coverage when they first become eligible and decide to sign up later, then they will pay a life-lasting penalty unless they meet certain exclusions. People can get the prescription drug coverage either through a standalone prescription drug plan, Medicare Part D or through a Medicare Part C plan.
However, Original Medicare does not cover dental care and routine vision or hearing care. Only emergency dental conditions or complicated dental procedures are covered. The same is the case with routine vision check-ups. The cost of glasses is generally not covered, but if people are suffering from eye conditions like glaucoma or cataracts, then it will be covered under Original Medicare.
People having Medicare Advantage plans have a good chance to include dental and vision coverage. Though it will likely be limited and nothing major would be covered. However, people having either Original Medicare or Advantage plan can purchase a separate plan to have a more extensive vision, dental, and hearing coverage.
Medicare beneficiaries who hop from country to country should know that basic Medicare plans do not provide coverage for medical care received outside the United States. Nevertheless, if beneficiaries have chosen an Advantage plan, then emergency medical services are often covered worldwide. Although routine care received overseas are not covered. Original Medicare enrollees also have the option to purchase a Medigap plan that provides coverage while traveling. However, the Medigap plan cannot be purchased by the Medicare Advantage plan enrollees. Medigap plan generally covers the cost of deductibles or co-insurance associated with basic Medicare, and some of these plans also provide coverage during overseas travel.
Seniors should know that Medicare does not cover long-term care that includes things like daily assistance for bathing and eating. Americans above 65 years of age spend a good amount of money in long-term care. However, some plans cover long-term care, though these plans are expensive and the insurance costs more for older people.
Seniors who are in the hospital should make sure whether they have been admitted for treatment or just for observation. For example, if a senior trip and fall and end up in the hospital and stay there for a few days. And if they need rehab for their injury, then such skilled nursing care is covered through Medicare Part A if they have been admitted to the hospital for at least three days. However, if the seniors are kept in hospital for observation then their rehab would not be covered.
Medicare also does not cover services like acupuncture, cosmetic surgery, and routine foot care. Seniors planning to enroll in Medicare should have comprehensive knowledge about its coverage option to avoid surprises. Everyone’s health condition is not the same, so all need to plan accordingly to make sure that they have the coverage they need when they enroll in Medicare.