Medicare, by itself, is very good coverage, often much better than what most people are accustomed to as they age into Medicare. However, there is certainly room for improvement. Our thoughts on how Medicare could be improved
Some of the aspects of medical care that are not covered, such as dental, vision and hearing for example, have often been discussed as possibly being added in to basic Medicare’s coverage. That would certainly be an improvement to the coverage offered by “original” Medicare.
Other changes that would potentially improve benefits offered by Medicare are reductions in the amount of the Medicare deductibles and out of pocket costs. It’s difficult to see that change happening any time soon, however, and this is why the majority of people on Medicare purchase some sort of coverage in addition to Medicare.
The biggest challenge that seniors face when going on Medicare is confusion about Medicare benefits, deadlines and processes. Because of the enormous amount of information that seniors receive leading up to their 65thbirthday or retirement, many seniors are paralyzed by the fear of making the wrong choice or confused by the system itself.
In our experience, many people applying for Medicare do not understand how to start the process of applying Medicare. Those that are already receiving Social Security benefits are automatically enrolled into Medicare upon turning 65, so that does simplify the process for people in that situation. But for those that are not yet receiving Social Security benefits, it is a challenge to know what to enroll in and when they should enroll. There is not one document that seniors receive from Medicare that explains, in easy-to-understand terminology, the steps that one should take when applying for Medicare.
Additionally, this is even more complicated for seniors that are continuing to work past age 65 or are covered by a group insurance plan of some type. The decision of whether or not to take Medicare when they are first eligible is a decision that leads to confusion and can have potential long-term consequences.
Medicare has late enrollment penalties for Part B (medical coverage) and Part D (Rx coverage). So if a senior does not enroll on Medicare’s pre-determined time schedule, they can face these financial penalties, which are steep and stay with you in perpetuity.
There are several medical services that are not covered by Medicare that can cause a problem for seniors and their families. Many people have the pre-conceived misconception that Medicare pays for everything. On the contrary, there are Medicare deductibles, coinsurance and co-pays that has spawned a whole industry of supplemental plans to fill in the Medicare “gaps”.
One of the areas that is not covered by Medicare is long-term care. We see this as a surprise to people on Medicare and their families because it is an area of care that so many seniors rely on later in life. However, Medicare itself does not cover nursing homes or custodial care. Now, there are insurance plans that you can purchase to cover that type of care, but these would, ideally, need to be purchased well before those benefits are actually needed.
Another medical service that is not covered by “original” Medicare is prescription drugs. Prescription drug coverage for Medicare beneficiaries is provided through Medicare Part D. This is always a separate plan, sold through a private company, and it must be signed up for separately (you are not automatically enrolled in prescription drug coverage in most situations). Also, if you delay enrollment into prescription drug Part D coverage, you may face higher premiums due to Medicare’s Part D late enrollment penalty.
Other medical care that is non-covered by Medicare are services for routine hearing, vision and dental care. There are some related aspects of these services that are covered, such as cataract surgery for example. But on the whole, routine care is not covered for hearing, vision or dental – this includes hearing aids, eyeglasses, and fillings, extractions, crowns, etc. You can purchase insurance to cover these things, but Medicare itself does not cover them.
Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved Our thoughts on how Medicare could be improved
Garrett is the founder/President of Secure Medicare Solutions, a leading, independent Medicare insurance agency. Since 2007, Garrett has worked with tens of thousands of people turning 65 or already on Medicare to understand, compare and choose Medicare insurance that fits their specific needs and situation.
His latest project is 65Medicare.org, an online hub for people just starting with Medicare, which is focused on distilling difficult Medicare questions into easy-to-understand resources.
Garrett resides in North Carolina with his lovely wife, Celeste, and three spirited children.View All Articles