Why does Medicare have so many coverage gaps, and is it designed that way on purpose?
Answered by 14 licensed agents
Answered by Tony Capraro III on April 15, 2025
Agent Licensed in NH & ME
Today, with healthcare costs rising, the original design has revealed six major gaps in its coverage. Therefore, yes, I think it was designed this way in the beginning, which makes it very confusing today. You need to make sure you have the right coverage and can’t afford the coverage of these gaps.
Answered by Larry Dalton on April 2, 2025
Broker Licensed in OK & TX
Answered by Ben Washington on April 8, 2025
Broker Licensed in IL, FL, MN, SC, TX & WI
Answered by Amy Putrino on March 25, 2025
Agent Licensed in RI, CT, FL & 11 other states
Answered by Tai Thao on June 23, 2025
Broker Licensed in WI, AR, NC & OK
Answered by Justin Lucas on May 8, 2025
Broker Licensed in IN, FL, IA & 11 other states
Answered by Steven Bleicher on June 4, 2025
Broker Licensed in AZ
Answered by Valentina Gatewood on April 15, 2025
Broker Licensed in CA, AZ, ID & NJ
Part A has a period deductible while Part B has a small annual deductible and an 80/20 coinsurance with unlimited out of pocket maximum.
It can become confusing with all the changes but reaching out and having a Broker can help make sure that feel less of the out of pocket with the right plans and options.
Answered by Harold Randolph on April 23, 2025
Broker Licensed in MI, IN, KY & OH
Answered by Denise Berg on April 2, 2025
Broker Licensed in CO, AL, AZ & 15 other states
Part A hospital services
Part B doctor and outpatient services
Part D prescription drugs
After these deductibles are paid, there are often gaps in what Medicare will pay for your covered health care, such as:
Part A of Medicare has expensive copays for people with long stays in hospitals and skilled nursing facilities.
Part B of Medicare pays only 80% of covered expenses for the costs of doctors, durable medical equipment and other outpatient expenses.
Copays and drug costs charged by Part D drug plans can differ among Part D insurers, even for the same drug.
Answered by Linda Davies on June 29, 2025
Broker Licensed in IL
Answered by Glenn Alterman on April 20, 2025
Broker Licensed in TX, AZ, CA & FL, NJ, OH & TN
Medicare’s structure creates space for private insurance companies to offer supplemental coverage (like Medigap or Medicare Advantage). This public-private hybrid model was intentional—it allows the government to provide a foundation, while the private market fills in the gaps.
Answered by Michael Martin on April 17, 2025
Broker Licensed in NJ, MD, MI & PA
Answered by Kelly Corbin on May 24, 2025
Agent Licensed in MS
Tags: Agent Interview Coverage The Medicare System
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