What is not covered under Medicare?

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The Limitations of Medicare Coverage

We often herald the benefits of Medicare coverage, considering how it provides financial support to those who need help in covering their medical and healthcare bills – but what about when the Medicare insurance ends and we are left to cover the remaining costs and expenses ourselves?

The fact is that despite Medicare being designed to provide financial support, the list of expenses and conditions under which Medicare coverage may not apply is extensive and often not completely understood by those who are newly eligible.

Where does Medicare end?

Once you have become eligible and signed up for your Medicare plan, you will start receiving benefits which range from the hospital coverage of Part A to the outpatient coverage of Part B, to the more advanced coverage of Parts C and D which include things like prescription drugs and extended hospital stays. 

However, despite each of these parts offering differing levels of support in different areas, Medicare comes with conditions and limitations. 

  • Parts B, C, and D all come with their own premiums and deductibles which must be paid by the beneficiary before or while their Medicare insurance pays out its own portion. 
  • Part A is not designed for long term hospital coverage, with coinsurance fees applicable after 60 days as an inpatient in hospital. 
  • Depending on your income level, additional premium fees may be required by Medicare Part D

A lot of beneficiaries overcome these limitations by signing up for a Medigap supplement insurance policy – however, even this does not cover all the costs of treatment and healthcare in full, with different private insurance companies charging different fees.

Are there any conditions under which Medicare cover may not apply?

Yes, in fact, there are a few instances where Medicare might not provide the full breadth of support you might expect – and that is why understanding and reading the fine print under each package is so important. 

For example, dental care, eye care, hearing aids, acupuncture, and cosmetic surgeries are generally not covered by any Medicare policy. Long term care is also not covered by any Medicare insurance policy. 

The best way to find out exactly what you receive with your Medicare coverage is to get in touch with a team of experts who can talk you through each of the packages and plans. Our team at Bobby Brock Insurance is always available to help and guide you through the Medicare process and help you understand exactly what costs you can expect.

Justin Brock

Justin Brock

The CEO and President of Bobby Brock Insurance. A nationally syndicated Medicare advisor, best-selling author of Medicare Breakdown: The Alphabet Soup of Medicare, and pacesetter for over 20,000 senior market insurance agents. Featured in many insurance-related publications for his Medicare and Health insurance... Read More »

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