| Tue, Apr 26, 2011 @ 09:00 AM

Original Medicare Doesn’t Cover Everything, but Additional Coverage is Available

Posted by Medicare Made Clear

Medicare Doesn't Cover EverythingWhile Original Medicare is comprehensive health insurance, some costs are covered by the beneficiary, like copayments, coinsurance and deductibles. And some services, like routine dental care and hearing aids, are not covered. But there are ways to get help for costs not covered by Original Medicare.

Original Medicare Beneficiaries (Part A and Part B)

If you or your spouse made payments to Social Security for at least 10 years, Medicare Part A, or hospital insurance, does not have a premium you need to pay. Medicare Part A helps pay for inpatient care in a hospital or skilled nursing facility. There is a deductible required before your Medicare Part A begins to cover your costs and a copay is required when services are rendered.

Medicare Part B requires a monthly premium. Part B helps pay for medically necessary services, including doctors’ services, outpatient care, home health services, some preventive care and other services. Medicare Part B also has a deductible and requires payment of a copay at time of service.

How can I get additional coverage?

Medigap plans (often called Medicare Supplement Insurance) can help Original Medicare beneficiaries with costs that Parts A and B don’t cover. There are ten standard Medigap plans available, all through private companies. Medigap plans can help with costs associated with:

  • Part A and B deductibles
  • Coinsurance
  • Additional hospital days
  • Foreign emergency medical expenses
  • Hospital and skilled nursing facility coinsurance
  • Blood transfusions
  • Some drugs the provider must give you
  • Some preventative care benefits

Medigap plans don’t cover long-term care (like nursing homes), or routine dental, vision or hearing care.

The cost for Medigap plans are determined by your place of residence and the private company that provides them, though the benefits are standard for each plan type. Be sure to compare costs, as the price can vary by provider for the same benefits.

Are there other ways to get extra help?

Yes. There are programs that make extra financial help available for those with lower incomes to help cover the costs of Medicare. Medicaid is the most commonly known program. Whether or not you qualify for low-income assistance, it’s always a good idea to proactively research Medicare options available in your area to make sure you’re getting the best coverage for your situation.

The family of UnitedHealthcare® Medicare Solutions plans are insured or covered by an affiliate of UnitedHealthcare®, a Medicare Advantage organization with a Medicare contract and Medicare-approved Part D Sponsor.

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