MEDICARE: What it DOES NOT cover

Many families we meet have the idea that MEDICARE will cover most of their LONG TERM CARE costs, like Assisted Living or Skilled Nursing as well as many of the medical costs associated with aging.

Some of the costs NOT COVERED by Medicare:

SKILLED NURSING:  There is much confusion here because many of the “rehab” facilities are inside of a Skilled Nursing community.  Your Medicare WILL pay for a certain amount of rehab, but please check your personal policy as there may be differences between conventional MEDICARE opposed to a MEDICARE ADVANTAGE plan.  If will be going to a skilled care community as a permanent placement, MEDICARE WILL NOT cover these costs.  Skilled care in an area like Raleigh, NC can range from $70,000 to well over $100,000.

HEARING AIDS:  Medicare will cover ear/hearing medical conditions, but traditional MEDICARE and Medigap plans will not cover routine hearing tests or the hearing aids themselves.  The hearing aids themselves can cost from several hundred dollars per pair at a discount retailer to thousands of dollars per pair for custom fitting.   Check Medicare Advantage plans for Hearing coverage.

DENTAL WORK: Original MEDICARE does not cover routine dental exams or “larger cost” procedures like root canals or dentures.  Check Medicare Advantage plans for possible coverage.

EYE CARE:  MEDICARE does not cover routine eye exams, glasses or contacts, but will cover procedures like Cataract surgery.

OVERSEAS TRAVEL/CRUISES: MEDICARE and most Medicare Advantage plans offer little or no coverage while overseas or on a cruise.  If you travel frequently, it would be important to seek out a comprehensive travel policy that covers doctors, room and if needed air transportation charges to a major care facility.

OTHER COSTS: If you have on-going care costs you need to check your policy.  An example would be that most policies DO NOT cover consumable items like Depends or over the counter meds, creams, etc.

Understanding the benefits and limitations of your MEDICARE policy is vital in putting together a solid long term care plan, working closely with your financial and elder law teams.

If you are interested, we offer free consultations where we can review costs, possible government benefits and the most important legal documents.



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