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Health Care Reform:

Health Insurance & Affordable Care Act

How to Pay for What Medicare Doesn’t Cover

Medicare will pay for a lot of your health care expenses. But whether you have Original Medicare or a Medicare Advantage Plan, you'll still have medical costs that your plan won't cover. Those expenses you have to pay, called out-of-pocket fees, can add up fast.

But there's good news. With a little research, you can get help from supplemental plans and other programs that will cut down your medical bills and keep more money in your pocket.

If You Have Parts A & B: 2 Ways to Pay Less

Most people on Medicare have Original Medicare, also known as Medicare Parts A and B. While Original Medicare should cover most of your care, it has these gaps.

Gaps in coverage:

  • Original Medicare doesn't cover some essentials. For instance, it does not pay for most prescription drug costs.
  • Even when Medicare covers a treatment, you still have to pay copays and coinsurance.
  • Most people have to pay a monthly fee, called a premium, for Medicare.

Fortunately, Medicare offers these choices to supplement your Original Medicare.

Prescription Drug Plans. Also known as Medicare Part D, a Prescription Drug Plan will help you pay for prescription medicines. You'll pay an extra fee each month for the plan, but you'll probably save a lot on pharmacy expenses.

Private companies sell prescription drug plans, but you can sign up for them through Medicare. To compare plans in your area and sign up, use the Medicare Plan Finder.

Medigap plans. Just like it sounds, a Medigap plan will fill some of the gaps in coverage with Original Medicare. Medigap plans help:

  • Pay copays and coinsurance.
  • Lower the deductible, which is the amount you have to pay out-of-pocket before Medicare pays toward your care.

What don't Medigap policies cover? Most don't pay for long-term care, dental care, hearing aids, eye exams, or eyeglasses.

To get a Medigap plan, you have to have Original Medicare. As with a Prescription Drug Plan, you also have to pay a monthly fee for a Medigap plan. The plans vary on what they cover and how much they cost. You can use the Medicare Plan Finder to choose a Medigap plan in your area.

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