What is one thing Medicare Part B typically does not cover?

Original Medicare (Parts A and B) does not cover routine dental care, routine vision care, hearing aids, most long-term custodial care, and outpatient prescription drugs in 2026.

Common Uncovered Services

• Routine dental care: Standard checkups, cleanings, fillings, tooth extractions, root canals, and dentures are excluded.
• Routine vision care: Regular eye exams, eyeglasses, and contact lenses are not paid for, though surgeries for medical eye diseases like cataracts or glaucoma are covered.
• Hearing aids: Original Medicare does not cover hearing aids or routine exams used to fit them.
• Long-term custodial care: Ongoing help with daily personal needs like bathing, dressing, or non-medical nursing home care is not covered.
• Outpatient prescription drugs: Standard Part A and Part B do not pay for regular prescriptions, requiring a separate Part D plan or a Medicare Advantage policy.

Yes, you can deduct Medicare premiums withheld from your Social Security check on your federal income taxes, provided you itemize your deductions and your total medical expenses exceed 7.5% of your adjusted gross income (AGI).

How the Deduction Works

• Itemizing required: To claim the deduction, you must file Form 1040 and itemize your deductions on Schedule A.
• The 7.5% threshold: You can only deduct the portion of your total qualified medical expenses (including Medicare Parts A, B, C, D, and Medigap premiums, plus out-of-pocket costs like copays and prescription drugs) that goes over 7.5% of your AGI.
• Self-employed exception: If you are self-employed and show a net profit, you may qualify for an above-the-line deduction for health insurance premiums without needing to itemize.

Finding Your Total Premiums

• Form SSA-1099: The Social Security Administration sends you an annual Form SSA-1099. This document lists the exact total of your Medicare premiums that were withheld from your checks over the prior year.

The best insurance to have with Medicare depends on your health needs and budget, choosing between a Medigap (supplemental) policy for maximum doctor choice or a Medicare Advantage plan for bundled extra benefits.

You can learn more about evaluating these choices through the Consumer Reports Guide to Medicare Advantage or the Medicare.org Senior Insurance Overview.

Option 1: Original Medicare + Medigap (Supplement)

• How it works: You keep government-managed Original Medicare (Parts A and B) and buy private supplemental insurance (Medigap) to pay for things like copays, coinsurance, and deductibles. You also need a separate Part D plan for prescription drugs.
• Best for: People who want predictable medical bills and the freedom to see any doctor in the U.S. who accepts Medicare without needing referrals.
• Top providers: Humana and Mutual of Omaha are widely trusted for Medigap plans.

Option 2: Medicare Advantage (Part C)

• How it works: Private insurance companies replace Original Medicare with an all-in-one plan that bundles Part A, Part B, and usually prescription drug coverage (Part D).
• Best for: People who want lower monthly premiums and extra perks like dental, vision, hearing, and fitness memberships.
• Top providers: UnitedHealthcare, Humana, and Aetna lead the market in size, availability, and customer satisfaction ratings.

Critics and beneficiaries advise caution with Medicare Advantage plans because of restrictions on care, unexpected costs, and administrative hurdles. While these private plans often feature low or zero monthly premiums and extra perks like dental or vision, they come with significant trade-offs.

Restricted Provider Networks

• Local limitations: Most plans use specific HMO or PPO networks, meaning you must see doctors and go to hospitals within the plan’s local area.
• No nationwide freedom: Unlike Original Medicare, which lets you see any accepting doctor nationwide, Medicare Advantage offers very limited coverage when traveling.
• Frequent changes: Provider lists can change annually or even during the year, meaning your favorite doctor might leave the network unexpectedly.

Prior Authorization and Denials

• Approval delays: Private insurers often require "prior authorization" (advance permission) for specialized care, MRIs, surgeries, or rehabilitation.
• Care obstacles: This review process can delay or block medically necessary treatments.

High Out-of-Pocket Costs

• Cost-sharing for serious illnesses: While plans have annual out-of-pocket maximums (up to thousands of dollars), treatments like chemotherapy or expensive infusions can trigger steep 20% coinsurance charges before you reach that cap.
• End-of-life complications: High utilization during severe or chronic illness can result in major expenses or coverage friction.

The "Medigap" Trap

• Locked-in coverage: If you try to switch back to Original Medicare after a 12-month trial period, moving to a Medicare Supplement (Medigap) plan often requires passing medical underwriting. Pre-existing health conditions can make it difficult or impossible to qualify for a good supplement later.

The average cost of Medicare Supplement Insurance (Medigap) across all policyholders is $217 per month, according to data from the KFF / Forbes. However, because medical benefits for each plan letter are completely standardized by the government, "the best" coverage is generally defined by the specific lettered plan you choose.

Monthly costs typically range from $30 to over $300+, heavily influenced by the plan type, your age, location, and the private insurance company.

Average Monthly Costs for the Top Medigap Plans

The most popular and highly rated Medigap options carry the following typical monthly premium ranges:

Top Insurance Companies and Pricing

Because coverage for a specific plan (like Plan G) is identical from company to company, the "best" provider is usually the one offering the lowest premium and the most stable pricing history. Industry evaluations from platforms like NerdWallet highlight several top providers:

• State Farm: Frequently ranked best overall due to minimal historic rate increases and low customer complaint volumes.
• Mutual of Omaha: Well-regarded for offering competitive rates on High-Deductible Plan G.
• AARP / UnitedHealthcare: Offers the widest nationwide availability, though users should look closely at local rate projections.

Key Factors That Change What You Pay

1. Pricing Method: Insurers price plans via three models: Community-rated (everyone pays the same regardless of age), Issue-age-rated (premiums are based on your age when you buy), or Attained-age-rated (premiums start low but automatically increase as you get older).
2. The "Open Enrollment" Window: The lowest rates are always locked in during your initial 6-month Medigap Open Enrollment Period (which starts the month you turn 65 and enroll in Part B). During this time, companies cannot deny you coverage or charge you more for pre-existing conditions.
3. Discounts: Many insurers offer household discounts (if two people in the same home enroll), automated payment reductions, or lower rates for non-tobacco users.