By Colleen Morrissey
Medicare is a federal health insurance program that provides vital coverage for millions of Americans age 65-and-up. But unfortunately there’s a widespread misconception that it provides comprehensive coverage.
“Medicare coverage can be complicated,” said Corinne Lofchie, a Medicare expert at Somerville-Cambridge Elder Services (SCES). “People often think that they’ll be all set when they enroll in Medicare, but we often have to change people’s thinking about that, because it doesn’t cover everything.”
Lofchie offered the following advice on three surprising things that Medicare doesn’t cover:
- Dental isn’t covered. Neither is vision or hearing care. There are now products that you can purchase to fill in those gaps, but if you just have Medicare, it doesn’t include coverage for dentures, eyeglasses, hearing aids, etc. This can be a big issue for many Medicare beneficiaries who need these services and supplies.
- Medicare won’t pay the nursing home. Medicare will pay for rehabilitation services, but not for long-term care, which may be provided in a nursing home. Long-term care services are paid for privately or with Medicaid (known as MassHealth in Massachusetts). You can also purchase long-term care insurance, but you should consult a financial planner first. Usually, these plans are considered affordable up until your mid-60s, and even then, they are often quite expensive.
- You might have a different plan from your spouse. Health insurance through an employer typically offers family or couple’s plans. Medicare is different, in that each individual in a household can have completely different coverage. You might choose a Medicare Advantage plan, while your spouse might use Original Medicare with a supplement. Or you might stay on your employer group health plan while you work, and your spouse might choose to take Medicare. It depends on the costs of each – you’ll want to look at the specific costs and coverage.
Lofchie is a counselor through the SCES SHINE program, which offers free health insurance information and support to Medicare beneficiaries in Somerville and Cambridge. For more information about the SHINE program, call the SCES Aging Information Center at 617-628-2601 or visit us online during regular business hours.
Somerville-Cambridge Elder Services (SCES) is a non-profit agency that supports the independence and well-being of older people in Somerville and Cambridge. For more information, check out the Things to Know When Turning 65 episode of Aging Well at the SCES Youtube Channel, or contact the SCES Aging Information Center at for free advice and guidance.
