Myth Vs. Fact: Medicare covers everything.
Original Medicare, made up of Medicare Part A and Part B does not cover “everything”. Part A, known as Hospital insurance, covers inpatient care in a hospital, skilled nursing facility care, home health care and hospice.
Part B is medical insurance covering outpatient care for medically necessary services, preventative services, durable medical equipment, and physician administered drugs. Keep in mind copays and coinsurance are applicable under Original Medicare.
What is not included with Original Medicare:
- Prescription drug coverage
- Dental, Vision, or Hearing
- Health Club Memberships and Fitness Programs
- Long Term Care
Not only are the above items not covered under Original Medicare, but it is important to note that Medicare Part B does not have an out-of-pocket maximum. Meaning for the 20% of co-insurance you are responsible for on Medicare approved expenses, there is no stop loss. If a Medicare beneficiary went to the hospital and had a $100,000 bill, they would potentially be responsible for $20,000 of that. That is why there is optional coverage available to help protect beneficiaries from the unlimited 20% and provide extras that Original Medicare does not cover. Working with a local and independent Medicare insurance agent ensures that you are getting the most out of your plan and understand your monetary responsibility. For help from a local Medicare guide, call VibrantUSA at 866-733-5111.