Does Medicare cover all services?

No, Original Medicare (Parts A & B) does not cover everything; it has significant gaps, especially for dental, vision, hearing, prescription drugs, and long-term care, and doesn't pay 100% of covered costs, leaving beneficiaries with deductibles, coinsurance, and copays. To fill these gaps, people often use Medicare Advantage Plans (Part C), Medicare Supplement (Medigap) plans, or separate Part D drug plans.

What are some things that Medicare doesn't cover?

Original Medicare (Parts A & B) generally doesn't cover routine dental, vision (glasses, exams), hearing aids, long-term custodial care, most cosmetic surgery, or prescription drugs (that's Part D). It also excludes services like acupuncture, most chiropractic care, private-duty nursing, and personal comfort items in hospitals (like TVs). Medicare Advantage (Part C) plans often fill these gaps with extra benefits like vision, dental, and hearing coverage, but it depends on the specific plan. 

Does Medicare fully cover everything?

There are some things Original Medicare won't cover. Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine physical exams.

Does Medicare pay 100% of anything?

No, Original Medicare (Part A & B) does not cover 100% of costs; it typically pays about 80% after deductibles, leaving you with 20% coinsurance for many services, plus gaps like dental, vision, and most drugs, requiring you to pay out-of-pocket or get supplemental coverage like Medicare Advantage (Part C) or Medigap. Some preventive services are covered at 100%, but most care has cost-sharing. 

Is Medicare alone enough?

No, Original Medicare (Parts A & B) typically isn't enough because it doesn't cover prescription drugs (needs Part D), has no out-of-pocket spending limit, and misses routine dental, vision, and hearing care, leading most beneficiaries to add Medigap (Supplement) or choose Medicare Advantage (Part C) for comprehensive coverage. Deciding what's "enough" depends on your health, budget, and comfort with risk, as Original Medicare leaves significant costs to you. 

Medicare Part A B C D Explained (and made simple!)

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

Is it better to go on Medicare or stay on private insurance?

Neither Medicare nor private insurance is universally "better"; the best choice depends on individual needs, but Medicare often offers lower overall costs and simplicity for seniors, while private insurance excels in covering dependents and potentially offering more choice with networks/out-of-pocket caps, though at higher premiums. Medicare boasts lower admin costs and standardized coverage, but Original Medicare lacks an out-of-pocket maximum, a feature typically found in private plans and Medicare Advantage (Part C). 

What Medicare is free for seniors?

Part A is free if you worked and paid Medicare taxes for at least 10 years. You may also be eligible because of your current or former spouse's work.

What is the 80 20 rule for Medicare?

The "Medicare 80/20 Rule" refers to two different concepts: the Affordable Care Act's Medical Loss Ratio (MLR), requiring most health insurers to spend 80% of premiums on care, and a new CMS rule for Home & Community-Based Services (HCBS) demanding 80% of Medicaid payments go to direct caregiver wages, aiming to improve workforce pay and stability. Separately, Original Medicare Part B often pays 80% of approved costs for outpatient services, with the beneficiary paying the 20% coinsurance. 

Can I get dental and vision coverage with Medicare?

While most Medicare Advantage plans cover preventive dental care like teeth cleanings and exams, as well as vision care with eye exams and eyewear allowances, sometimes that's not enough. If you need crowns or dental repair work, or if you have special eyewear needs, your out-of-pocket costs could add up.

What is the most popular Medicare coverage?

The most popular Medicare plan is Medigap Plan G, especially for new enrollees, because it offers comprehensive coverage similar to the discontinued Plan F, covering nearly all Original Medicare out-of-pocket costs except the Part B deductible, making it a favorite for predictable expenses. While Plan F still has many current enrollees, Plan G is the top choice for those starting Medicare, followed by Plan N for cost savings with copays. 

What are the disadvantages of Medicare for all?

The estimated cost of Medicare for All is around USD 32 trillion dollars over 10 years. Medicare for All would also require privately insured individuals to forgo their insurance and join the government program. The price tag and the requirement that all join makes Medicare for All unlikely to come to pass.

Does Medicare pay for a colonoscopy?

Yes, Medicare (Part B) pays for screening colonoscopies, covering 100% of costs if your doctor accepts assignment and no polyps are found, though you pay 15% if they remove tissue (making it diagnostic); frequency depends on your risk, generally every 10 years (average risk) or 24 months (high risk). 

Do I really need supplemental insurance with Medicare?

Supplemental insurance is advisable for those with Medicare to help cover out-of-pocket costs and gaps in coverage, offering financial protection for deductibles, coinsurance, and other medical expenses not fully covered by Medicare.

What is the best health insurance for seniors on Medicare?

There's no single "best" health plan, as it depends on your needs, but top providers for Medicare Advantage (Part C) include Humana, UnitedHealthcare, Aetna, and BCBS, offering diverse benefits like $0 premiums, extra perks, and strong networks, while Medigap (Medicare Supplement) complements Original Medicare by filling gaps, with popular carriers like AARP/UHC, Anthem, and Cigna providing standardized policies (Plans G, F, N), with personalized choices best found via your State SHIP counselor or broker. 

Does Medicare cover 100% of a hospital stay?

No, Original Medicare (Part A & B) does not cover 100% of hospital bills; beneficiaries pay deductibles, coinsurance, and copays, but you can get full coverage by adding Medicare Supplement (Medigap) plans or choosing a Medicare Advantage plan. Part A covers the first 60 days of a hospital stay (after a deductible), but after that, you pay daily coinsurance, and there's no limit on your total costs unless you have supplemental coverage.
 

What are the 5 things Medicare won't cover?

Original Medicare (Parts A & B) doesn't cover most dental, vision (like glasses/contacts), hearing aids, routine foot care, and long-term custodial care, plus many alternative therapies, cosmetic surgeries, and prescription drugs (without Part D). You'll need supplemental plans (like Medigap or Part C) or separate insurance for these common needs. 

Does everyone have to pay $170 a month for Medicare?

If you don't get premium-free Part A, you pay up to $565 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($202.90 in 2026).

At what age do you stop paying Medicare premiums?

Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. See Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.

Is there a grocery allowance for seniors on Medicare?

One in four Medicare Advantage plans offer some type of financial assistance for groceries aka the Medicare grocery allowance.

Who qualifies for an extra $144 added to their Social Security?

You qualify for an extra ~$144 on your Social Security check if you have a Medicare Advantage (Part C) plan with a "Part B Giveback" benefit, which refunds some or all of your Medicare Part B premium, appearing as extra cash in your check, but eligibility depends on living in the plan's service area and paying your own Part B premiums. The "144" figure was common when the Part B premium was around that amount, but the actual refund varies by plan and location, potentially exceeding the full premium. 

What is the best secondary insurance if you have Medicare?

Best Medicare Supplement Insurance Companies in 2026

• UnitedHealthcare / AARP – Best Plan Pairing: Plan G or Plan N.
• Cigna Healthcare – Best Plan Pairing: Plan G.
• Humana – Best Plan Pairing: Plan N.
• Aetna (CVS Health) – Best Plan Pairing: Plan N.

What states have the worst Medicare Advantage plans?

States often cited for weaker Medicare Advantage performance include Louisiana, Mississippi, Kentucky, West Virginia, and Florida, due to challenges with care access, provider shortages, and quality issues like higher rates of avoidable hospitalizations and inappropriate medication prescriptions, though specific rankings vary by report and focus (e.g., satisfaction vs. overall system). Other states like New York, California, Texas, and Michigan appear on lists for low member satisfaction with specific plans, not necessarily the whole state's system. 

Do all doctors accept Medicare?

Physicians are not required to participate in Medicare, though the vast majority of them choose to do so.