Five Expenses Supplemental Medicare Insurance Won't Cover

May 7th 2016

Supplemental Medicare insurance is supposed to pay for medical expenses that Medicare doesn't cover. These policies, often called Medigap insurance, are advertised as a way to pay for the medical expenses ignored by different Medicare plans. However, after you purchase a supplemental policy, you may be surprised by the medical treatments, care and devices that a Medigap policy won't cover. Purchasing eyeglasses, receiving dental care and buying hearing aids are all common medical costs that aren't covered by supplemental insurance paired with a Medicare policy.

Long-Term Care

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If you need short-term care inside the home as you recover from illness, Medicare and Medigap policies will help you pay for the assistance you need. However, if you find that you need long-term care to help you with routine activities, Medigap or Medicare will not pay for nursing or a home health aide. People who need long-term care that involves managing a disease can, however, enter long-term care hospitals, nursing homes or hospices.

Hearing Aids

While Medicare Part B will cover hearing and balance tests required by your doctor, neither Medicare nor Medigap insurance will pay for the cost of hearing aids. Hearing tests covered by Medicare must be ordered to diagnose a specific medical condition. If your doctor orders these tests, you should still expect to pay 20 percent of the negotiated cost plus your Medicare Part B deductible. Routine hearing exams are not covered by either type of insurance.

Eyeglasses or Contact Lenses

Medigap and Medicare policies won't pay for eyeglasses or contact lenses, even if you need them to perform daily activities. However, if you require corrective lenses due to an intraocular lens implant, Medicare Part B will pay 80 percent of the cost after the deductible is paid.

Vision or Dental Care

Supplemental Medicare insurance policies won't cover routine vision or dental care. If you need fillings, cleanings or other dental treatments, you'll need to pay for them out of pocket or purchase dental insurance. If you enter a hospital, Medicare Part A will pay for certain dental expenses that are essential to your health.

You must also pay for your own vision exams under most circumstances or purchase additional insurance. However, if you have diabetes, glaucoma or macular degeneration, Medicare Part B may cover yearly eye exams required to monitor any symptoms that result from these diseases. 

Private-Duty Nursing

If you would like private nursing while you stay in your home, Medigap policies may not cover this expense. Medicare Part A and Part B should pay for speech pathology, physical therapy and intermittent-skilled nursing care. However, if you need 24-hour care or only need help completing personal tasks, the private-duty nursing required will not be covered by a Medigap plan. People who find themselves in need of these services can seek long-term residential care, which will be covered by Medicare.

Most people will find that they need at least one of these medical services as they age. For this reason, it's important to develop a plan that will allow you to pay for the medical care you'll need. In some cases, it may be as simple as earmarking some of your retirement funds toward your future medical expenses. However, if the possibility of ballooning medical costs will keep you up at night, you may want to purchase additional private insurance.

Summary:

  • Don't expect supplemental Medicare insurance to cover all of your medical expenses.

  • Make plans or purchase insurance to pay for dental care, vision examinations and medical devices.

  • Consider how to pay for nursing if you become unable to complete routine tasks but have no other health problems.

  • Plan for these health-related expenses before you need treatment that Medigap or Medicaid doesn't offer.

Sources:

http://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html

http://www.medicare.gov/coverage/eyeglasses-contact-lenses.html

http://www.medicare.gov/coverage/eye-exams.html

http://www.medicare.gov/coverage/macular-degeneration.html

http://www.medicare.gov/coverage/dental-services.html

http://www.medicare.gov/coverage/hearing-and-balance-exam-and-hearing-aids.html

http://www.medicare.gov/coverage/home-health-services.html

http://www.medicare.gov/coverage/long-term-care-hospitals.html

http://www.aarp.org/health/medicare-insurance/info-01-2011/understanding_medicare_medigap.html

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