As the leaves fall and Halloween approaches, it’s the perfect time to talk about something truly scary — Medicare coverage gaps. While ghosts and goblins might only show up once a year, unexpected medical bills can appear when you least expect them and haunt your finances long after October ends.
If you’re reviewing your Medicare plan this fall, here are some “spooky” coverage gaps to look out for before they come back to bite you.
1. The Phantom of the Missing Prescription Coverage
Many retirees assume their health plan automatically covers prescriptions, but that isn’t always true. Without Part D or a Medicare Advantage plan that includes drug coverage, you could be paying full price at the pharmacy. Always double-check your plan’s formulary and confirm that your medications are included.
2. The Ghost of Limited Networks
Not all doctors and hospitals participate in every Medicare Advantage network. If you see a specialist or travel often, make sure your preferred providers are still covered under your plan for 2025. Choosing a plan with a limited network can turn into a real nightmare when you need care away from home.
3. The Curse of High Out-of-Pocket Costs
Original Medicare doesn’t cover everything. Deductibles, coinsurance, and copays can add up quickly, especially after a hospital stay or major procedure. A Medicare Supplement plan (Medigap) can help protect you from frightening out-of-pocket surprises.
4. The Invisible Dental, Vision, and Hearing Costs
Original Medicare does not cover routine dental, vision, or hearing care — and that’s a gap that can quietly drain your wallet. Consider whether a Medicare Advantage plan or standalone policy can help fill in those missing pieces of protection.
5. The Power of an Annual Review
The Annual Enrollment Period (AEP) runs from October 15 to December 7, giving you the chance to review your current plan and make changes. Even if you’re happy with your coverage, it’s wise to review each year — because plans change, and so do your needs.
Don’t let coverage gaps creep up on you. A quick review of your Medicare options today can keep your finances — and your peace of mind — protected through the year ahead. The best way to stay safe from scary surprises is to work with a trusted local agent who can help you compare plans and ensure your coverage fits your health needs.