Around this time is the opening of enrollment of Medicare. It is important to understand if you are getting the best ‘bang for your buck’! It may be time for a revaluation of your particular needs. Here are some key tips to keep in mind this upcoming season.

  1. Past needs compared to present needs.
    • How is your plan handling your current coverage? Are there lower costs that best suit your necessities?
    • Make sure your primary care physician accepts your current plan. If not, you may need to go a different route.
    • Look over your prescription drugs coverages.
    • Be aware and understand risks involved.
    • Keep in mind late penalties and longer enrollment times.

While looking at Medicare plans, it is crucial to not only understand where your coverage lies, but where it doesn’t, and it can be somewhat shocking. There are multiple areas that some Medicare plans will not get any blanket.

  • Dental services:
    • Dental care is generally not covered by Medicare or Medicare supplements. Did you know that the average of routine teeth cleanings and x-rays adds up to be approximately $288? Retired couples are expected to spend around $18,500 (4) straight out of pocket for dental services.
  • Vision and hearing:
    • Medicare does cover hearing tests when it is medically related, but if it is just a result of older age, the individuals are generally on their own with that. A hearing test, consultation and fitting can cost up to $250 with no insurance. When hearing aids are bought, $1,000 to $1,500 later, folks still need to be aware to have money on the side for five-year replacements and maintenance (2).
  • Long-term care:
    • At least 70% (1) of retired individuals result to some sort of custodial care in their later years. The downside is that most Medicare coverage does not reach the certain, daily tasks, like dressing, bathing and feeding. According to the Genworth Cost if Care survey data from the previous year, 2020, the cost of home health was around $150 a day alone. Imagine how much that can add to for about 5-10 years (1).
  • Mental health:
    • Some may hear the beach calling their name when retirement comes into their eyesight, but others do not always feel this way. Giving up work, something that you may have done each day for 30 years or so, is a drastic life change and can result in some negative feelings, like anxiety, depression and other stress related emotions. Medicare may not cover everything someone needs to get the help that could get them through the tough days. After you meet the deductible, Medicare may cover 80%, but the other 20%, which could cost $50/hour or more, must be paid out of pocket (5).
  • Overseas travel:
    • This is an area that is under thought, but can be very important to realize. Retirement comes into play, most couples can already envision themselves traveling to Europe or the Caribbean islands, sometimes even for longer periods of time. Most Medicare plans to do not cover medical costs outside the United States. If you and your spouse are interested in traveling abroad for some parts out of the year, you may want to consider short-term travel insurance that provides cushion with foreign health or medical emergencies that may arise unannounced. It is important to note that these insurance plans do only cover for limited time and deductibles do apply (3).

With Medicare, you should always expect the unexpected. It is worth it to understand exactly what coverage you do and don’t have. Those medical expenses can add up, whether you are healthy or not. Meet with your financial advisor now and review your current plan. This way, you are able to make a contingency plan that has more of a strategy to best fit your retirement income. It is okay to need help and get the resources you may need in order to live a comfortable, pleasant and enjoyable retirement.

Sources: Centers for Medicare & Medicaid Services (1); “Medicare coverage and hearing aids”, August 2, 2021 (2); “Does Original Medicare Cover Overseas Travel?”, March 12, 2021 (3); time.com/money; kiplinger.com (4); “How Much Does Therapy or Counseling Cost?” Depression RSS2, March 29, 2016; costhelper.com (5)

These policies have exclusions and/or limitations. The cost and availability of Long Term Care insurance depend on factors such as age, health, and the type and amount of insurance purchased. As with most financial decisions, there are expenses associated with the purchase of Long Term Care insurance. Guarantees are based on the claims paying ability of the insurance company.