Medicare covers a lot, but not everything. For example, Medicare doesn’t cover most dental, vision, and hearing care, including hearing aids. It also doesn’t cover most non-emergency transportation or care outside of the U.S. Even when Medicare covers your care, there may be costs left to you, like copays and coinsurances, that can add up. Today we’ll discuss ways to add on to your Medicare to help you access these types of care.
Medicare Advantage Plans may provide supplemental benefits.
Medicare Advantage Plans, or MA Plans, may cover things that Medicare can’t cover. These are called supplemental benefits. Examples of common supplemental benefits are dental care, vision care, hearing aids, and gym memberships. MA Plans can also offer benefits that are not primarily health-related for beneficiaries who have chronic illnesses, like meal delivery, transportation for non-medical needs, and home air cleaners.
It's very important to read a plan’s coverage rules around supplemental benefits. You may hear that a plan covers dental care and assume that means the plan will cover cleanings, x-rays, fillings, crowns, and dentures. But sometimes, plans’ supplemental benefits are less comprehensive than you may initially assume—a plan may only cover routine cleanings or have restrictions like how often you can use your dental benefits. If a Medicare Advantage Plan claims to cover many supplemental benefits, remember to ask questions, get answers in writing, and read coverage rules to know exactly what this means.
Medigaps can help cover your out-of-pocket costs.
Medigaps are health insurance policies sold by private insurance companies that offer standardized benefits to work with Original Medicare. If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first. Medigaps may cover deductibles, coinsurance, and copayments. Medigaps may also cover health care costs that Medicare does not cover at all, like emergency care when traveling abroad.
Remember, Medigaps only work with Original Medicare. If you have a Medicare Advantage Plan, you cannot buy a Medigap.
If you want to purchase a Medigap policy, you need to find out the best time to buy one in your state. In most states, insurance companies must only sell you a policy at certain times and if you meet certain requirements. If you miss your window of opportunity to buy a Medigap, your costs may go up, your options may be limited, or you may not be able to buy a Medigap at all.
When you’re ready to buy a Medigap, you should compare your options and decide which plan you want. You can compare Medigaps on Medicare.gov. After choosing a Medigap, you should contact the insurance company directly to enroll.
Medicaid and other strategies may help you access other kinds of care.
Still have questions?
Your SHIP is here for you! You can contact your SHIP for any Medicare-related questions or concerns you have. SHIP counselors are government funded to provide trusted, unbiased Medicare counseling at no cost to you. (Depending on your state, your SHIP may go by another name.) Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
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