Christopher Carrino
What Medicare Doesn’t Cover — And What You Can Do About It
The Surprise Many Seniors Face - and How We Can Help
For many people turning 65, enrolling in Medicare feels like crossing a major item off the to-do list. Finally-health coverage in retirement. But here's what often gets overlooked: Original Medicare (Parts A & B) doesn't cover everything. In fact, many essential services and costs fall outside its scope.
At Simply Medicare, we meet clients every day who are surprised to learn just how much they could still owe out-of-pocket, even with Medicare. The good news? You don't have to figure it out alone. We're here to walk you through what's covered, what's not, and what smart steps you can take now to stay protected.
What Is (and Isn't) Covered by Original Medicare?
Original Medicare is made up of Part A (Hospital Insurance) and Part B (Medical Insurance). Together, they offer a solid foundation-but there are important gaps.
What's Covered:
- Part A: Inpatient hospital stays, skilled nursing facility care (short-term), hospice care, and some home health services.
- Part B: Doctor visits, outpatient care, preventive services, durable medical equipment.
What's Not Covered (But Commonly Needed):
- Prescription drugs (you'll need Part D or another plan)
- Routine dental care, dentures, or cleanings
- Vision exams or eyeglasses
- Hearing exams or hearing aids
- Long-term care (nursing home or in-home custodial care)
- Overseas emergency care
- Most cosmetic or elective procedures
- Routine foot care (except in special medical cases)
Why It Matters: The Financial & Personal Impact
These coverage gaps can quickly turn into major expenses-and they're not uncommon. For example:
- A pair of hearing aids can cost $3,000-$6,000.
- Dental crowns or implants can cost thousands per tooth.
- Long-term care in a nursing home averages over $90,000/year in many states.
- Without Part D, a single brand-name prescription could cost hundreds per month.
For people on a fixed retirement income, unexpected healthcare costs can create real financial strain-not to mention emotional stress on families trying to fill the gaps.
4 Smart Steps to Close the Medicare Coverage Gap
There's no one-size-fits-all answer-but there are proven strategies to help cover what Medicare doesn't. Here's how to get started:
1. Review Your Health Needs & Goals
Are you on medications? Have you had dental or vision issues in the past? Planning ahead can help you build the right coverage mix.
2. Add a Medicare Supplement Plan (Medigap)
These plans work alongside Parts A & B to help cover out-of-pocket costs like deductibles, copays, and coinsurance.
3. Consider Medicare Advantage (Part C)
Many Advantage plans bundle hospital, medical, and drug coverage-plus extras like dental, vision, hearing, and fitness benefits.
4. Add Targeted Coverage
Supplement your Medicare with:
- A Part D prescription plan
- Dental/Vision/Hearing insurance
- Long-term care insurance
- Final expense or life insurance
At Simply Medicare, we help you build a plan that fits your needs-not just what's standard.
Real-World Example:
Mary, 67, retired teacher
Mary enrolled in Original Medicare thinking it would cover most of her healthcare. But after a root canal and crown costing over $2,000-and facing an unexpected $1,500 hospital bill after a brief ER visit-she called us.
We helped her add a Medigap Plan G to reduce out-of-pocket hospital costs and found her a dental/vision plan that now helps pay for checkups, cleanings, and glasses.
Common Issues Clients Face
- Assuming Medicare covers everything- and getting surprised by bills.
- Delaying supplemental coverage- and losing guaranteed enrollment rights.
- Skipping Part D- and facing late penalties or high prescription costs later.
- Choosing plans without understanding networks, drug tiers, or out-of-pocket limits.
Our job is to help you avoid these pitfalls before they become costly.
How Simply Medicare Helps
We're not here to push a product. We're here to help you make informed, confident choices about your healthcare. With over 20 years of experience and access to dozens of top-rated carriers, we'll walk you through your options in plain English.
You'll get:
- A one-on-one free consultation
- A full review of your healthcare needs
- A custom-fit plan that fills the gaps without breaking your budget
- Ongoing support-even after you enroll
And because we're independent, our loyalty is to you-not any one insurance company.
Ready to Fill the Gaps in Your Coverage?
Don't wait until a medical bill catches you off guard. Let's build a plan that protects your health and your finances-now and for the future.
Schedule your free consultation today to get started. We'll make the process simple, personal, and pressure-free.
Serving clients in all 48 licensed states, Simply Medicare is based in [Insert City, State], proudly offering honest Medicare guidance wherever you are.