The Unexpected Costs of Medicare (And How to Plan for Them)

Medicare is essential—but it's not free. Many people are surprised by the out-of-pocket costs that pop up after enrolling. At Mountaineer Health and Life Insurance, we help folks across West Virginia and beyond avoid those surprises with smart, personalized planning.

Here’s a breakdown of the most common unexpected Medicare costs—and how to protect yourself.

💸 1. Unexpected Costs of Premiums for Medicare Parts B & D

While Part A is usually premium-free, you’ll pay for:

• Part B: Starting at $185/month in 2025

• Part D (prescription drug plans): Additional monthly premium depending on coverage

💬 Let’s estimate your monthly Medicare costs—before you enroll.

💳 2. Deductibles, Copayments & Coinsurance

Original Medicare doesn’t cover everything. Expect:

• A $1,676 deductible for each hospital stay

• 20% coinsurance on most outpatient services

• Deductibles and copays under Part D

💬 We’ll walk you through what services cost—and how to reduce the burden.

🚫 3. No Out-of-Pocket Maximum

Unlike private insurance, Medicare has no annual spending cap. A serious illness or accident could leave you with thousands in unexpected bills.

💬 Ask us how to cap your costs with supplemental coverage.

💊 4. Prescription Drug Deductibles & Copays

Even with Medicare Part D, you may face annual deductibles and copays for your prescriptions. These costs can vary widely depending on your plan and medications—and they add up fast.

💬 Let us help you choose a plan that minimizes drug costs all year long.

😷 5. No Dental, Vision, or Hearing Coverage

Original Medicare doesn’t include:

• Routine dental care

• Vision exams or glasses

• Hearing aids

These are critical services for aging adults.

💬 We’ll show you plans that include these essential benefits.

🧓 6. No Long-Term Care Coverage

Medicare doesn’t pay for:

• Assisted living or nursing home stays

• In-home help with daily activities (bathing, dressing, etc.)

These services can cost up to $5,000+ per month.

💬 Ask us about long-term care insurance or hybrid solutions.

🔄 Medicare Supplement vs. Medicare Advantage: What’s the Difference?

If you want to reduce your out-of-pocket costs, you’ve got two main options:

🔹 Medicare Supplement (Medigap)

✔️ Pairs with Original Medicare

✔️ Covers deductibles, copays, and coinsurance

✔️ Nationwide access—no network restrictions

✔️ Separate Part D plan needed

🧭 Great for people who want flexibility and low surprise costs.

🔸 Medicare Advantage (Part C)

✔️ Combines Parts A, B, and usually D

✔️ May include dental, vision, and hearing

✔️ Has a max spending cap for your protection

✔️ Requires staying in-network (HMO/PPO)

🧭 Best for those who prefer bundled coverage with a traditional health insurance feel.

💬 Not sure which is best for you? We’ll help you compare side-by-side.

Compare your Medicare plan options with Mountaineer Health and Life Insurance!

🤝 We’re Here to Help—No Guesswork, No Pressure

At Mountaineer Health and Life Insurance, we help people across West Virginia make confident Medicare decisions.

✅ Free personalized consultations at no-cost

✅ Local, family-run service you can trust

✅ Real answers—not sales pitches

📞 Call us today or 📅 book your no-cost Medicare plan review online—we’re here to help you plan smart and retire with peace of mind.