Medicare Has a Major Gap All Retirees Should Know About

Source The Motley Fool

Key Points

  • While Medicare might cover a good number of your health-related needs in retirement, it doesn't pay for everything.

  • Expect to pay for dental care and other key services on your own unless you have a Medicare Advantage plan.

  • Come up with a strategy for long-term care coverage, since Medicare won't pick up the tab.

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

There's a reason a lot of people push themselves to wait until age 65 to retire instead of ending their careers a bit earlier. Age 65 is when Medicare eligibility typically begins. And without Medicare, the cost of securing health coverage can be prohibitive.

But that doesn't mean it's all smooth sailing once you enroll in Medicare. While many of your health-related needs may be covered at that point, there are still some gaps that could come back to bite you. And it's important to prepare for those ahead of time so your retirement budget isn't thrown for a loop.

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Key services Medicare doesn't cover

While Medicare might pay for you to undergo a screening test or cover the cost of a doctor visit to diagnose an infection, you should not expect Medicare to cover every single health-related cost. In fact, Medicare famously (or infamously) does not cover a number of important health services for seniors, including dental care, eye exams, and hearing aids.

And don't expect Medigap, or supplemental insurance, to pay for those things easier. Enrollees in original Medicare often buy Medigap coverage to help defray the cost of things like coinsurance and deductibles. But while Medigap might help with those, it won't pay for services Medicare doesn't cover itself.

Now if you enroll in a Medicare Advantage plan, you may find yourself with coverage for dental exams, vision services, and hearing aids. But Medicare Advantage isn't for everyone, so it's not necessarily a strategy you should count on until you've done your research.

Don't forget about long-term care

In addition to the services mentioned above, another key service Medicare typically won't pay for is long-term care. And while it may not be routine like teeth cleanings, it's something that absolutely needs to be on your radar.

Based on national averages, a year-long nursing home stay could cost you almost $130,000 for a private room if you end up needing that care, according to CareScout. And Medicare may not pay for a dime of it.

Furthermore, while enrolling in a Medicare Advantage plan might get you covered for things like dental and vision services, it generally won't help you get nursing home care paid for. You'll need strong savings or long-term care insurance for protection.

All told, it's important to know what Medicare does and doesn't cover ahead of your enrollment. That way, you can plan accordingly and avoid big budget-busting surprises.

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