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Identifying Health Insurance Coverage Gaps


Date Published: on Wednesday, August 23, 2017

Many people don’t realize that Medicare does NOT cover all medical needs, which creates gaps in health care coverage. To help identify where you might have gaps, it’s important to do an annual checkup of your health care and financial needs – since these often change from year to year. Use these three questions to help you get started:

What isn’t covered by Medicare?

Medicare covers many health care costs, but it doesn’t cover everything. This creates gaps in health care coverage, which can mean more costs for you if you have to pay for health care items out-of-pocket. According to Medicare.gov, some items that are not covered include most dental care, eye examinations, dentures, cosmetic surgery, acupuncture, hearing aids, and routine foot care.

You should also consider how much coverage Medicare provides for each service. For example, many people think skilled nursing services and home health care are fully covered by Medicare, but there are specific limitations that could cause gaps in coverage.

“I encourage all Medicare beneficiaries to learn more about Short Term Recovery Care insurance,” says Dave Peters, a VP at Medico Insurance Company. “It can be a very necessary type of coverage to fill an important gap by helping pay for home health care, nursing facility, and assisted living facility care.”

Is Medicare Supplement insurance right for me?

Medicare Supplement insurance, which is commonly referred to as Medigap insurance, is sold by private insurance companies to help pay some of the health care costs that Medicare doesn't cover like copayments, coinsurance, and deductibles. It’s important to understand that Medicare Supplement plans are standardized (or in other words, they are all the same), which makes price and quality two important factors to consider.

“When selecting Medicare Supplement insurance coverage, it’s important to think about your personal and financial health as well as your anticipated needs for the future,” explains Peters. “Do you prefer a plan that offers full coverage? Or do you need a plan to fit your monthly budget? These are key questions to ask yourself when assessing your health care needs.”

How do I get started?

When it comes to knowing what’s best, you have the power to live confidently by taking charge of your health insurance coverage. Choosing the right plans for your total health care coverage does not have to be confusing, and there are many resources to help you find solutions that will keep you protected and healthy.

Simply remember to:

• Educate yourself with credible online resources, such as Medicare.gov.

• Review your plan every year as your health and financial needs change.

• Consider talking with an agent who specializes in Medicare.

Key things to know about health insurance coverage

• You still have Medicare Part A and Part B when you purchase Medicare Supplement insurance.

• Comparing price and selecting a quality insurance company are important parts of the decision.

• Other health insurance coverage, such as Short Term Recovery Care, may be important to filling your coverage needs.