The hidden Medicare gaps that could drain your retirement savings

You’ve worked hard, saved carefully, and counted down the days until retirement. The idea of finally having time for family, hobbies, or long-awaited travel feels within reach. But many retirees discover too late that their biggest expense isn’t the vacation or the move to a smaller home—it’s healthcare.

While Medicare forms the foundation of healthcare coverage for millions of Americans, it leaves significant gaps that can quickly drain retirement savings. With Medicare's annual Open Enrollment period running from October 15 through December 7, now is the perfect time to understand these coverage gaps and plan accordingly.

The reality of Medicare's coverage gaps

Nearly 44% of Medicare beneficiaries report difficulty hearing, and more than one-third (35%) report difficulty seeing, yet Original Medicare provides virtually no coverage for routine dental, vision, or hearing care. This leaves millions of seniors facing thousands of dollars in annual out-of-pocket expenses for essential healthcare services.

The numbers are sobering. Nearly 11% of beneficiaries report unmet dental needs, 4% report unmet vision needs, and 2% report unmet hearing needs because of cost. These aren't luxury services—they're fundamental to maintaining independence and quality of life as we age.

What Original Medicare doesn't cover

Original Medicare (Parts A and B) excludes coverage for:

• Routine dental care including cleanings, fillings, crowns, and dentures
• Vision care such as eye exams for glasses, prescription eyewear, and contact lenses
• Hearing aids and most hearing-related services
• Long-term care services
• Most prescription drugs (unless you add Part D)

The 2025 Part B deductible is $257 per year, and even when Medicare does cover limited services in these areas, you'll typically pay 20% of the Medicare-approved amount.

Also read: Could SeniorCare help cut your prescription costs? Some seniors in this state are finding out

The surprising truth about supplemental coverage

Even if you have supplemental coverage through Medicare Advantage plans, you're likely still paying more than you expect. More than 90% of Medicare Advantage plans provide coverage for dental, vision, or hearing services, but the coverage often comes with significant limitations.

Recent research reveals that even Medicare Advantage enrollees with coverage still pay 65% of vision costs, 76% of dental costs, and 79% of hearing costs out of pocket. This means supplemental benefits, while helpful, still leave substantial financial responsibility with beneficiaries.

Understanding your coverage options

Medicare Advantage plans

Medicare Advantage plans can offer additional benefits beyond Original Medicare, including dental, vision, and hearing coverage. However, these benefits vary significantly between plans, and you'll need to carefully review:

• Annual benefit maximums (often $1,000-$3,000 per year)
• Network restrictions for providers
• Copayments and coinsurance requirements
• Prior authorization requirements

Medigap supplemental insurance

Medigap policies help cover costs that Original Medicare doesn't pay, like copayments and deductibles. However, most Medigap plans don't include dental, vision, or hearing benefits.

Stand-alone policies

You can purchase separate dental and vision insurance policies, though these often have waiting periods, annual maximums, and may not provide significant savings for major procedures.

Also read: Medicare covers 10 surprising services for free—are you missing out?

Making the most of Open Enrollment

October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year. Here's how to approach this critical period:

Start your review early

Don't wait until December to evaluate your options. Plans can change their benefits, costs, and provider networks annually, so even if you were satisfied last year, your plan may not meet your needs in 2025.

Calculate total costs

Look beyond monthly premiums to understand your total potential costs, including:

• Deductibles and copayment
• Out-of-network charges
• Annual benefit limits for supplemental services
• Prescription drug costs

Consider your health trajectory

Think honestly about your likely healthcare needs. If you've been putting off dental work or need new glasses, factor those costs into your plan comparison.

Hope on the horizon

There's encouraging news for the future of Medicare coverage. The Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045) has been introduced in Congress, which would provide Medicare coverage for routine dental cleanings and exams, basic and major dental services, emergency dental care, dentures, routine eye exams, eyeglasses, contact lenses, routine hearing exams, and hearing aids.

While legislative action takes time, this represents growing recognition that these services are essential healthcare needs, not luxury items.

Don't let coverage gaps drain your savings

The key to avoiding unexpected healthcare costs is understanding your coverage before you need care. Whether you choose Original Medicare with supplements, a Medicare Advantage plan, or a combination of coverage options, make sure you understand exactly what you're paying for and what gaps remain.

Long-term care presents another significant financial risk, as Medicare provides very limited coverage for extended care needs. Consider whether long-term care insurance makes sense for your situation, especially while you're healthy enough to qualify for coverage.

Also read: Why reviewing your Medicare plan every year could save you money and stress

Read next:

• Are you spending too much on Medicare? Here’s how to cut costs in retirement
• Medicare 2026 update: What to know about premiums, benefits, and plan choices
• When to sign up for Medicare: Key dates and tips to avoid penalties

Key Takeaways

• Original Medicare doesn’t cover important healthcare needs like dental, hearing, vision and most prescription medications, so retirees should plan ahead for these extra costs.

• You may need to buy additional health insurance policies, such as a Part D drug plan or private coverage for dental, hearing, vision and long-term care, as Medicare won’t pay for everything.

• The annual Medicare Open Enrollment period, from October 15 to December 7, is usually your only chance each year to change or update your health insurance plan, unless you qualify for a special exception.

• It’s important to review your current cover, note any gaps, and start exploring other plans early so you don’t miss out on better value or more suitable healthcare options in retirement.

What healthcare costs have surprised you most since turning 65? Have you found strategies that work well for managing Medicare's coverage gaps? Share your experiences and tips with fellow readers in the comments below.