I just retired and started using Medicare. Went to the dentist but found out my cleaning wasn’t covered. Why doesn’t Medicare cover things like this?
A: Well, we can’t answer the ‘why’ – you would have to ask the U.S. government about that one. But we can help shed a bit more light on something you found out the hard way, and that many others find surprising as well: Original Medicare (Parts A & B) doesn’t pay for all your healthcare expenses in retirement.
For example, as you experienced, Medicare doesn’t cover routine dental visits; it also doesn’t cover routine vision care, hearing aids, most long-term care needs, deductibles and co-insurance, and prescription drugs (though you can add Part D for this particular coverage). That’s a fairly large coverage gap. This is why, according to the Kaiser Family Foundation, 83 percent of Original Medicare enrollees currently also have some kind of supplemental coverage – either through a Medigap policy (offered through private insurers), an employer-sponsored retiree healthcare plan, or Medicaid. So, it sounds like you’re one of the 17 percent of beneficiaries with no supplemental coverage. In this case, just understand that you’ll need to pay out-of-pocket for these expenses moving forward, and you won’t have the protection of any sort of annual out-of-pocket limit.
Therefore, if your budget allows, the Simply Money Point is that it could be worthwhile to look into buying supplemental coverage, such as a Medigap policy. (Important note: If you miss your Medigap Open Enrollment window, you’re not guaranteed the ability to buy a policy.) You could also consider switching to a Medicare Advantage Plan since these typically have more comprehensive coverage than Original Medicare (but not always). But a decision like this shouldn’t be made on a whim; you need to take into account, among other factors, your health, your doctors, medications, budget, and even where you live.