What’s Covered, What’s Not by Medicare Parts A and B

Why It Matters:

  • Original Medicare (managed by the federal government) doesn’t cover everything.
  • Medicare will cover a portion of medical expenses in your older age, but be prepared to pay deductibles, copays, coinsurance, plus premiums, depending on what you sign up for.
  • Generally speaking, Original Medicare won’t cover medical care outside the U.S.
  • You may be able to find other coverage for services not covered by Original Medicare.

Catherine Tsai tkc.profilePicture Written by: Catherine Tsai | Transamerica
Oct. 11, 2017

2 Min readClock Icon

Medicare helps seniors pay a portion of their medical costs, but it doesn’t cover everything.

The rest of what you’re about to read is for educational purposes only, so don’t consider it to be financial advice or a suggestion to buy anything. (Your financial professional can help you evaluate what options might be right for you.) But this information could give you an idea of what to expect as you get ready to pay for medical expenses after age 65.

Whether you opt for Original Medicare, which is managed by the federal government, or a Medicare Advantage Plan provided by a private insurer, you’ll pay some expenses yourself.

As with health insurance that you might get from an employer or on your own, you can typically expect to pay deductibles, copays, and coinsurance, not to mention premiums for at least Part B (coverage of medical services) and Part D (prescription drug coverage).

What’s not covered

Beyond that, there are certain services that are not covered by Original Medicare, including:

  • Long-term or custodial care.
  • Dentures and most dental care.
  • Eye exams for getting glasses prescriptions.
  • Cosmetic surgery.
  • Acupuncture.
  • Hearing aid or exams to be fitted for one.
  • Routine foot care.

Finding extra coverage

Those who opt for Original Medicare, which includes Part A to cover hospital care and Part B to cover medical equipment and services, can choose to add Part D for prescription drug coverage and Medicare Supplement Insurance (Medigap) for additional coverage, if they want it. Medicare.gov has more information.

You also may be able to find a Medicare Advantage Plan from a private insurer that includes coverage that’s more tailored to your needs. While Original Medicare generally doesn’t cover medical care outside the U.S., you may be able to buy other coverage to fill at least some of the gap.

Prevention really might be the best medicine

Of course, staying healthy may be one of the best ways to keep medical costs down in the first place. The American Heart Association recommends 150 minutes of moderate exercise per week. In one study, people who followed that guideline had annual healthcare costs that were roughly $2,500 less than those who didn’t.

Not everyone thinks about budgeting for potential health costs after age 65. Heck, not everyone thinks they’ll ever retire, at any age. But medical costs are worth keeping in mind − along with all your plans for rest, relaxation, travel, and fun in your 70s and beyond.

Things to Consider:

  • It’s never too early – or too late – to talk to a financial professional about building a strategy to help you pay for medical expenses now and into the future.
  • Medicare.gov has a whole page where you can look up whether something is covered.
  • Staying active and taking care of yourself could help you keep medical costs low into old age.

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