What Medicare Doesn’t Cover (And How to Fill the Gaps)
If you’re nearing retirement and getting ready for Medicare, you might assume it covers just about everything. I get it—a lot of my clients thought the same thing at first. But the truth is, Medicare leaves some pretty big gaps. And if you’re not prepared, those gaps can lead to surprise bills and a lot of stress. In this post, I’ll walk you through exactly what Medicare doesn’t cover, why it matters, and the simple ways you can fill in the gaps without breaking the bank.
Table of Contents:
Let’s Clear Up a Common Medicare Misconception
What Medicare Actually Covers
What Medicare Leaves Out
Dental
Vision
Hearing
Long-Term Care
Prescription Drugs (Part D)
Why These Gaps Can Be a Big Deal
How to Fill the Gaps (Without Getting Overwhelmed)
Dental/Vision/Hearing Plans
Hospital Indemnity Coverage
Long-Term Care Insurance
Medicare Supplement (Medigap) Plans
Medicare Advantage Plans
Finding the Right Fit for You
Wrapping Up: You Deserve Peace of Mind
FAQ
1. Let’s Clear Up a Common Medicare Misconception
If you’re like most people I talk to, signing up for Medicare feels like finally reaching the finish line. You’ve worked hard, paid into the system, and now it’s time to enjoy reliable health coverage, right?
Well… kind of.
The reality is, Medicare gives you a great starting point—but it doesn’t cover everything. In fact, it leaves out some of the very things you’re most likely to need as you get older.
I’m not saying this to scare you—I’m saying it so you can make smart, confident choices. I’ve seen firsthand how much easier life gets when you plan ahead.
2. What Medicare Actually Covers
Let’s start with the basics. Original Medicare has two parts:
Part A (Hospital Insurance): Covers hospital stays, hospice care, and some short-term skilled nursing or home health.
Part B (Medical Insurance): Covers doctor visits, outpatient services, preventive care, lab work, and things like X-rays.
That’s the good news.
But there are deductibles and coinsurance to deal with—and a whole bunch of things it doesn’t touch at all.
3. What Medicare Leaves Out
Here’s what a lot of people don’t realize until they’re facing a big bill:
❌ Dental Care
No coverage for routine dental work. That means:
Cleanings
Fillings
Crowns
Root canals
Dentures
Unless it’s a medical emergency in the hospital, Medicare won’t help with dental.
❌ Vision Care
You’re on your own for:
Eye exams
Eyeglasses or contacts
Routine vision checks
❌ Hearing Services
Hearing aids can cost thousands—and Medicare doesn’t cover them. That includes:
Exams
Devices
Fitting and maintenance
❌ Long-Term Care
This is a big one. Medicare does not cover things like:
Assisted living
In-home caregiving
Ongoing nursing home care
You get short-term help after a hospital stay, but if you ever need daily care, that’s out-of-pocket.
❌ Prescription Drugs
Unless you enroll in Part D or have a Medicare Advantage plan that includes drugs, you won’t be covered for prescriptions.
4. Why These Gaps Can Be a Big Deal
Let’s be honest—this isn’t just about coverage. It’s about peace of mind.
I’ve seen clients delay care because they didn’t want a surprise bill. I’ve had folks come to me after a hospital stay or a dental emergency wishing they had known sooner.
These gaps can lead to:
Hefty out-of-pocket costs
Stress on you and your family
Avoidable health issues
But it doesn’t have to be that way.
5. How to Fill the Gaps (Without Getting Overwhelmed)
Here are some simple, affordable ways to protect yourself:
✔ Dental/Vision/Hearing Plans
These plans are easy to add and very budget-friendly.
Many cover 2 cleanings a year, glasses, and hearing aids.
Some start at around $25/month.
✔ Hospital Indemnity Insurance
This one is a game-changer. If you’re hospitalized, you get a cash payout.
Use it for co-pays, travel costs, lost income, or whatever you need.
Costs usually start under $30/month.
✔ Long-Term Care Coverage
There are modern options that won’t eat up your savings.
Some policies are tied to life insurance or annuities, which gives you flexibility.
✔ Medicare Supplement (Medigap)
Covers deductibles, co-insurance, and some of those “sneaky” costs Medicare leaves out.
Great if you want the freedom to see any doctor who takes Medicare.
✔ Medicare Advantage (Part C)
These plans bundle everything: Medicare + extras like dental, vision, hearing, and often drug coverage.
Premiums can be very low, but you’ll be in a network.
6. Finding the Right Fit for You
This is where I come in. Because the right coverage really depends on things like:
How often you see doctors
Whether you travel
What medications you take
Your family health history
There’s no one-size-fits-all. But I promise it doesn’t have to be overwhelming. I’ll walk you through it step by step.
7. Wrapping Up: You Deserve Peace of Mind
Medicare is a great foundation. But it was never meant to be your entire safety net.
If you’ve made it this far, give yourself credit—you’re working hard to protect your health and finances.
If you’re unsure where to start or just want to make sure you’re not missing anything, I’m here. No pressure. Just a helpful conversation.
8. FAQ
Q: Can I add dental and vision coverage any time?
A. Yes! Most of these plans are available year-round.
Q: What’s the difference between Medigap and Medicare Advantage?
A. Medigap helps cover costs that Original Medicare doesn’t. Medicare Advantage is an all-in-one plan that includes extras.
Q: I’m healthy now. Do I really need long-term care insurance?
A. Yes—if it fits your budget. You want to qualify while you’re healthy and lock in better rates. Most people don’t plan for this until it’s too late.
Q: How do I know what’s best for me?
A. Let’s talk. I can help you make sense of your options, based on what matters most to you.
