6 Huge Holes in Original Medicare You May Want to Fill In Before 2026

Source The Motley Fool

Key Points

  • Original Medicare doesn't cover dental, vision, hearing, or long-term care benefits.

  • You can purchase additional health insurance policies to fill in some of these gaps.

  • The Medicare open enrollment period for those plans ends on Dec. 7.

  • The $23,760 Social Security bonus most retirees completely overlook ›

If you've ever had sticker shock from a hospital bill, you know how important the right insurance coverage can be. During your career, you often take whatever plan your employer offers or whatever you can afford. But once you turn 65, you're eligible for Medicare.

This typically forms the backbone of your retirement healthcare coverage, but it's far from perfect. It has six gaping holes that could snare you if you ignore them. Fortunately, the current Medicare open-enrollment period gives you a chance to change your coverage until Dec. 7, 2025.

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Patient discussing something with doctor.

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6 important things Original Medicare doesn't cover

Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). The former covers in-patient hospital stays while the other covers doctor visits and many outpatient treatments.

Most people don't pay a Part A premium, but you'll pay one for Part B. In 2025, this is $185 per month. It usually comes right out of your Social Security checks if you're receiving them. This is expected to rise to around $206.20 in 2026, though the government hasn't released the exact premium amount yet.

After you've paid this, you'll still have a 20% co-pay on many Medicare-covered services. And you won't have coverage for the following six things:

  1. Dental care
  2. Vision care
  3. Hearing aids
  4. Long-term care
  5. Prescription drugs
  6. Care outside the U.S.

Self-funding these services can get expensive quickly, especially when you're talking about long-term care. Fortunately, there are other health insurance policies that cover these things.

How to fill in the gaps

Here are some other types of insurance policies you might want to consider in addition to or instead of Original Medicare:

1. Medicare Advantage plans

Medicare Advantage plans, also known as Medicare Part C, are an alternative to Original Medicare. They're available through private health insurers and cover everything in Original Medicare as well as some extras. This could be the right choice if you only want a single deductible and premium to worry about.

However, Medicare Advantage plans can be a bit more restrictive in terms of provider networks. You may also need to contact your primary-care doctor for a referral before your Medicare Advantage plan will cover any specialist visit.

2. Medicare supplement plans

Medicare supplement plans, also known as Medigap plans, are health insurance policies you pair with Original Medicare to fill in some of the gaps above. Private insurers offer these plans, which come with their own deductibles and co-pays.

You can't have a Medicare supplement and a Medicare Advantage plan at the same time. You must choose one or the other.

3. Medicare Part D plans

Medicare Part D plans are supplementary plans that cover prescription drugs. These are also available through private health insurance companies, and you can view the options available to you on Medicare's website. Part D plans have their own costs, so you'll have multiple premiums to track if you go with one of these.

4. Dental and vision insurance

You could also look into purchasing separate dental and vision care policies if you want coverage for these things but don't want to pay for a Medicare Advantage plan.

Another option is a dental discount plan. This is a membership program you can enroll in to reduce your dental costs. You pay an annual fee and then receive pre-negotiated lower dental care costs at participating dentists. Similar programs exist for vision care.

5. Healthcare policies for outside the U.S.

If you plan to travel outside the U.S. a lot in retirement, you may want to look into international-travel medical insurance. This covers healthcare costs you incur abroad. Or if you plan to retire in another country, you could look into a health insurance policy in that country instead.

6. Long-term care insurance

Long-term care insurance can be expensive as far as policies go, but it's cheaper than paying for this care completely out of pocket. If you shop for it while you're relatively young -- in your 50s -- you'll typically get a better rate than if you wait until you're older to buy coverage.

Start comparing your options now

You can purchase long-term care insurance and private dental, vision, or international-travel medical insurance at any time of year. But if you're interested in a Medicare Advantage, Medicare supplement, or Part D plan, you only have a small window when you can make a change for 2026.

The open enrollment period ends on Dec. 7. If you don't choose a new policy by then, you'll have to wait until next year's open enrollment period to make changes.

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