It’s best to be clear on what Medicare will & won’t pay for.

Just because Medicare is often referred to as “medical insurance” doesn’t mean it’s comparable to comprehensive health insurance coverage provided by an employer.

Medicare is not the easiest thing to navigate and constantly evolving, so it’s best to seek support as you and your parents work through its labyrinth. On the front page of the Medicare website, Medicare.gov, there’s a list of resources that are available to help folks get answers to their Medicare questions, find doctors, providers, suppliers, etc.

First things… As you and your parents begin to shop during Medicare’s open enrollment  beginning October 15th and ending December 7th, you need to know that Medicare does not cover dental, vision and/or hearing aids.

Here are some other examples of what Medicare WILL AND WON’T pay for:

Medicare Will Pay For

• Medicare will pay for a diagnostic hearing test that a doctor may order as a result of an injury or illness.
• Medicare will pay for tests and medical treatment for vision problems that develop as a result of injury or illness.
• Medicare will pay for tests and or dental treatments that developed as a result of injury or illness.

Medicare Will NOT Pay For

• Medicare won’t pay for routine hearing tests or hearing aids.
• Medicare won’t pay for dental exams, cleanings, root canals or orthodontic work.
• Medicare won’t pay for routine vision tests, contact lenses or glasses.

One of the biggest myths of Medicare is that it operates as the health insurance provided by a previous employer. When in reality, Medicare has gaps in the coverage due to rising deductibles and co-payments.

Once you realize that your parents’ Medicare plans have gaps, it’s best to begin shopping for a health plan to close these gaps by purchasing a Medicare Supplement Plan also referred to as Medigap.

Another potential advantage that comes with purchasing a Medicare Supplement Plan (Medigap) is that historically, they have covered a portion of costs for dental, vision and hearing tests. Also, in some cases, these plans’ additions come with discounts toward hearing aids, glasses or contact lenses.   

If your parents are considering retiring in the next six months, they should attempt to get the most out of the comprehensive health insurance being offered by their employer before they retire. So make sure they schedule any routine hearing vision and/or dental visits. If they’ve been stalling on getting new glasses, contact lenses or hearing aids, there is no time like the present to do so. During your parents’ last visits, be sure that their health care providers know that soon you will be transitioning over to Medicare and their providers may extend the fee schedule that their employer previously negotiated with them for their services.

Also, if  your parents are preparing for retirement, they may want to look into long-term care to address their health needs in their 80s and 90s. This is due to Medicare and long-term care having two distinctly different objectives.

Medicare is for treatment to help you recover from an illness or an injury. Long-term care is custodial care to help frail people carry out common activities like showering, moving around the home, and or preparing food.

For more information on Medicare, to compare the health plans and other resources available visit Medicare.gov. A good place to begin is under the heading “What Medicare Covers.”