Medicare covers many essential healthcare services, but it doesn’t cover everything. Out-of-pocket costs, coverage gaps, and specific needs can leave many beneficiaries looking for additional protection. That’s where supplemental health coverage comes in to help fill those gaps and provide more peace of mind.
Original Medicare is a government-funded and administered healthcare insurance program for seniors, those with disabilities and those with certain health conditions. Original Medicare does provide coverage for many medically necessary health care services from primary physicians, specialists and chronic conditions and hospitalization.
Original Medicare has deductibles, copays, and coinsurance, which vary depending on the care received and the service provided.
But there are many things that Original Medicare doesn't cover, including:
Click here to see what else Medicare doesn't cover
Supplemental health coverage refers to additional insurance policies that complement Medicare coverage. These policies help pay for expenses or services that Original Medicare doesn’t cover. They can be customized and combined to meet individual health requirements and financial situations.
There are a variety of supplemental insurance coverage options, and they can provide financial support in different ways. It’s not always the big, expected expenses that catch people off guard, but rather the gaps that can make a significant difference.
Some real-life examples where additional coverages can help:
In these situations, supplemental coverage can help reduce financial strain and provide a little more predictability.
Additional coverage can help manage unexpected medical expenses and ongoing care costs.
Because Medicare doesn't cover everything, supplemental coverage can help fill in gaps like dental, travel, or specialized care, creating a more comprehensive coverage.
Supplemental coverage makes healthcare expenses more manageable and easier to plan for.
Additional health insurance coverage provides confidence that you’re better protected in all kinds of scenarios.
As we highlighted above, Original Medicare doesn't cover all health services you will need, and there are gaps in coverage and expenses that can quickly add up. One way to fill these coverage gaps and protect financial responsibility is with additional Medicare health insurance plans, including a Medigap policy or Medicare Advantage plan. Medigap plans can help cover gaps, and Medicare Advantage plans often include additional benefits like dental, vision and hearing.
What’s the Difference: Medicare Advantage Plans vs. Medicare Supplements
Original Medicare does not cover basic dental care like routine exams and cleanings, or more extensive procedures like fillings and crowns. Additional coverage can be obtained to help cover the costs of essential dental care services. Some options include Medicare Advantage plans with dental benefits or standalone dental plans.
Find out more about Dental Insurance Options
Original Medicare does not cover care that is received outside of the U.S. Some Medigap policies may, but most additional coverage doesn't either. This is why obtaining travel medical insurance coverage is essential while traveling outside the United States.
Find out more about Travel Medical Coverage
Cancer indemnity insurance is a type of supplemental coverage that makes a cash payout if the policyholder receives a qualifying cancer diagnosis. Unlike standard health insurance, which typically pays medical providers directly, cancer insurance provides funds directly to you. The benefits can be used however is most helpful to you, such as medical expenses or any regular living costs.
Find out more about Cancer Insurance Coverage
It's important for seniors and their families to consider long-term care options. Research indicates that 70% of individuals who are 65 years old will need some form of long-term service and support before they pass away. Since Medicare does not cover extended nursing home or assisted living care, it is essential to financially prepare for this situation.
Long-term care insurance or other investment vehicles, such as long-term care annuities, can provide critical financial support for the high costs associated with long-term care.
Find out if Long-term Care Insurance is Worth the Investment
When choosing what types of supplemental health coverage you might need, it's important to consider several factors. Assess your current health status, future medical outlook and family history, as this can help you determine if you need additional coverage like hospital or cancer indemnity insurance. You'll also want to consider any additional benefits that are important to you, such as vision, dental, or hearing coverage, and look for plans that align with your individual needs and lifestyle.
You'll also need to evaluate your budget and what you can afford regarding premiums, deductibles, and out-of-pocket expenses; finding a plan, or a combination of coverage that fits your financial situation while meeting your healthcare needs, is essential.
By considering these factors, you'll be better equipped to choose the right supplemental health coverage to enhance your Medicare plan.
Many types of supplemental coverage can be obtained at any time, but not all. For instance, enrollment in Medicare plans such as Medigap policies and Medicare Advantage plans should be completed at key times, such as when you first enroll in Medicare (your initial enrollment period) or during the Annual Enrollment Period (AEP).
Other types of coverage, like indemnity insurance plans, life insurance, dental or vision, can be purchased at any time, although it's important to get the coverage before you need it to avoid any waiting periods, exclusions, and to have the coverage and benefits when they are needed.
It's important to keep in mind that a change in one type of coverage should include reviewing all types of coverage to ensure you are well protected.
Choosing supplemental coverage isn’t one-size-fits-all. The right combination of plans can help reduce financial stress and ensure your healthcare needs are more fully covered.
Understanding your options is the first step to building a Medicare plan that fits your needs today and in the future. Let the trusted team at Twin City Underwriters help you take the next step.
Reach out today to get started.
Sources:
https://news.twincityunderwriters.com/news/long-term-care-insurance-is-it-worth-the-investment
https://aspe.hhs.gov/reports/what-lifetime-risk-needing-receiving-long-term-services-supports-0
https://www.medicare.gov/providers-services/original-medicare/not-covered
Navigating insurance options can feel overwhelming, but you don’t have to do it alone. At Twin City Underwriters, we provide guidance across a variety of coverage types, including Medicare, supplemental indemnity plans, vision and dental insurance, travel coverage, life insurance and more. Our goal is to help you make informed decisions and feel confident in your coverage at every stage of life. Schedule a one-on-one meeting with one of our insurance brokers to get your questions answered!