By Beth Dow
Solutions By Beth

The 2018 Open Enrollment Period for Medicare opens on Nov. 1 and runs through Dec. 15.

If you or a loved one is new to Medicare, you owe it to yourself to find out all you can now so there are no surprises later. What you may not realize is that there are some services that Medicare does not cover.

Let’s begin with the basics. Medicare has two parts – A and B. Part A covers hospital stays, skilled nursing, hospice and some home health services. But keep in mind, this coverage comes with a $1,340 deductible per benefit period and there is a “cap” on the benefits received. Part B covers doctor visits, outpatient services, and medical equipment.

Singles who make less than $85,000 a year (based on tax returns from two years prior, so 2016 tax returns) pay $134 a month with a deductible of $183. Most often you will pay 20 percent of services after the deductible is met.

There is also a Part D that will pay for prescriptions. And a Part C or a Medicare Advantage Plan which will cover expenses that Part A, B and D do not cover.

But there are many expenses that are not covered under Medicare. Routine vision checks, eyeglasses, and contacts are not covered. Hearing Aid costs are not covered. Medicare also does not pay for routine teeth cleaning, x-rays, fillings or root canals. It does not pay for dentures or gum or oral surgery. Custodial Care – which includes non-medical home care, assisted living and nursing home care – is not covered by Medicare. Neither are Chiropractic treatments nor acupuncture.

If you are spending your “golden” years traveling, you should also be aware that Medicare does not cover you when you are outside of the United States. There are Medicare Advantage plans that will cover emergency costs out of the U.S. and you can purchase a Medigap Policy that can help pay up to $50,000 of medical expenses while you are outside of the country.

One last surprise to be aware of. If you are held in the hospital under observation and then require rehabilitation, Medicare will not pay for your rehab. You must be admitted to the hospital for 3 days in order for your Medicare to kick in for the rehabilitation. Always ask your hospital to admit you. Just because you spend the night in the hospital, does not mean you have been 
admitted.

Spend October learning the facts and finding out what plans will work best for you. You will be making decisions that you have to live with for a year. Make the best educated decision for you and your loved one.

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Beth Dow is a Dementia & Alzheimer’s Educator, CAEd, Geriatric Case Manager and Certified Senior Advisor. Most recently, she has authored a very popular book locally – “My Loved One Has Dementia. Now What?”. She can be reached via email at: beth@solutionsbybeth.com.