When we speak with people who are new to Medicare, they are often surprised that the program doesn’t cover everything. That’s why we recommend ancillary insurance plans for our clients.
The most common healthcare needs not covered by Medicare are dental, vision, and hearing. But ancillary plans help fill a variety of coverage gaps. In this post, we look at the more common types of ancillary insurance and what you should look for in a plan.
Buying Dental Insurance
The average dental plan has low monthly premiums but limited coverage. Annual limits are often surprisingly low while deductibles and co-pays can be surprisingly high. For example, most dental plans cover routine cleanings at 100 percent (once you meet your yearly deductible). But, you’ll pay 50 percent of the cost for common procedures such as root canals and crowns.
Before buying an individual policy, check to see whether you qualify for group coverage. Options include TriCare for military veterans, AARP, and policies through the Affordable Care Act marketplace.
What to look for in an individual policy
Look carefully at the limitations on an individual policy before buying. Most insurers cover preventive care from the beginning, such as yearly cleanings and x-rays. But if you need dentures, new crowns, or similar treatments, most policies make you wait 12 months. This helps guard against people who only sign up for one of these expensive procedures.
Dental coverage typically comes with significant out-of-pocket costs. Even good policies usually only cover 50 percent of most non-preventive procedures. You’ll get better coverage and prices if you compare plans and providers.
Also, make sure your dentist is in the provider network. If you don’t have a dentist, talk to friends and family for recommendations. Or, review the State Board of Dental Providers or Dental Association in your state. You’ll see any complaints and reviews as well as licensing information.
How to Find Vision Insurance
There are two basic types of vision insurance: benefits plans and discount plans.
A vision benefits plan resembles a traditional insurance policy, with monthly premiums and co-pays for covered services. Look for a plan that covers a comprehensive eye exam every year, even if you don’t currently need corrective lenses. These exams help detect a variety of conditions early. Policies typically include a provider network and cover set amounts for frames and lenses. Surgical procedures are generally not covered.
Discount vision plans are what they sound like: they offer a discount on vision services. Monthly premiums are typically lower, with plan members receiving a discount on covered services. Discounts vary but usually fall within the 15 to 35 percent range. You’ll likely get a larger discount by using certain providers.
Which choice is right for you depends on your vision needs – as well as what you expect them to be in the near future. When comparing plans, look at more than the monthly premium. The provider network, frame allowance, co-pays, and deductible all contribute to overall satisfaction with your vision plan.
Hearing Aid Insurance
Medicare covers diagnostic hearing tests when your doctor suspects conditions that affect balance. It does not, however, cover routine hearing tests or hearing aids. And few Medicare Advantage plans offer this level of coverage.
Most states have no laws regarding hearing aid insurance. But, there are a couple of providers who offer hearing aid insurance policies and extended warranties.
Other Ancillary Insurance Products
In addition to the Big 3, many Medicare recipients look for:
- Hospital indemnity insurance
- Cancer insurance
- Short-term care insurance
Hospital Indemnity Insurance
Also known as hospitalization insurance, indemnity plans pay you benefits when you are hospitalized. Benefits vary per provider, but may include payment for:
- Ambulance services
- Emergency room services
- Inpatient and outpatient procedures
- Urgent care center services
You can also find hospital indemnity plans that are not tied to your healthcare plan in any way. In other words, instead of covering co-pays, these plans simply pay you a lump sum. How you spend that money is up to you.
For example, if you have Original Medicare plus a Medigap plan and are admitted to the hospital, your Medigap plan pays your co-insurance costs. However, if your indemnity plan offers lump sum payments, you collect even if your Medigap plan already covered your co-insurance costs.
Cancer insurance policies work much the same way hospital indemnity plans work, typically in the form of lump sum payments delivered directly to you. Details vary according to the plan and insurer you choose, but may include payment for the initial diagnosis, chemotherapy, and radiation treatments.
For both cancer and indemnity insurance, lump sum payments help cover a variety of expenses not covered by traditional health insurance. You can use them to pay for transportation costs, hotel stays for family members supporting you during treatment, or to make up lost income.
Short-Term Care Insurance
Medicare’s coverage for short-term care is extremely limited. And, it doesn’t even cover the two most common types of post-hospital care required: intermediate care and custodial care. Intermediate care is similar to skilled nursing care but is not required daily. Custodial care is assistance with daily living tasks, such as meal prep and bathing.
The items covered by a short-term care policy vary according to the insurer and plan you choose.
If you need assistance sifting through your ancillary insurance options, the licensed agents at Medicare Solutions can help. We work with a wide array of private insurers offering multiple plan types. This is how we help our clients find the ideal policy to meet their unique needs. Call us toll-free at 855-350-8101 to get started.
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