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Beyond Basic Medicare: Understanding Medicare Supplemental Coverage

By Ron Pollack Modified: August 2, 2013 at 11:03 am •  Published: August 2, 2013
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Ron Pollack, Executive Director, Families USA
August 2013

 

 

Although Medicare provides vital health insurance for about 50 million seniors and people with disabilities, most people with Medicare have some form of additional coverage. Why is this coverage so important? And what are your options for getting this coverage? Let’s take a look.

 

Q: What gaps does Medicare have?

A: Medicare provides very important basic health insurance. However, it has gaps in the services it covers and in what beneficiaries have to pay out of pocket. Medicare has limited or no coverage for vision, hearing, dental, and long-term care. In terms of what beneficiaries have to pay, in addition to premiums, they often have large deductibles. And many services, like doctor visits and lab tests, come with substantial co-insurance (often 20 percent). Finally, unlike most other health insurance, Medicare does not have lifetime or annual out-of-pocket limits.

 

Q: How do people supplement Medicare?

 

A: Because of these major gaps, most people with Medicare have some kind of supplemental coverage. About one-third of beneficiaries have supplemental coverage from a former employer, but this coverage is becoming less common.

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