The Drawbacks of Medicare

Medicare is a federally funded program that provides health insurance for senior citizens and other eligible individuals. It has many advantages, such as the ability to cover medical treatment at low cost. However, Medicare also has some drawbacks related to coverage, eligibility and payments. Although these disadvantages do not decrease Medicare benefits, you should be prepared when you face them.

Premium Payments

• Although Medicare is public health insurance for senior citizens and other eligible participants, only part of Medicare coverage is premium-free. This is Part A, which covers in-patient care. Although Part A covers the costs of hospital stays, hospice care and skilled nursing facilities, it does not help pay for medical costs, such as doctors' visits and preventive care. If you need help with other health care costs, you will need to pay monthly premiums as you would with any private insurance provider. Since many senior citizens do not have the same income they had when they were working, paying these monthly premiums can become a burden.

Medicare Tax

• Another disadvantage of Medicare is that, since it is funded by Medicare tax, every employee is required to pay into it. As of 2011, Medicare tax corresponds to 1.45 percent of an individual's wage. The main problem with this situation is that, for someone who does not want or need Medicare Part A at retirement age, either because he has other types of insurance or is in good health, he is still required to pay these taxes, regardless of his choices or needs.

Medicare Advantage Plans

• Medicare Part C, also known as Medicare Advantage Plan, is one of the main drawbacks of Medicare. Although Medicare Advantage Plans give you the opportunity to enroll in private insurance that provides more coverage than standard Medicare, some of its disadvantages do not compensate for its benefits. In an Advantage Plan, you cannot see a doctor who is not a provider in the plan. Medicare Advantage Plans also limit some treatments. If you need a specialist or a specific treatment and your plan does not deem it is necessary, your plan will not help you pay for the costs of the specialist or treatment.

Medicare Part D Gap

• Another main disadvantage of Medicare is the gap in Part D coverage. Part D helps pay for the costs of prescription drugs but only up to a certain limit. As of 2011, if you reach $2,840 in expenses annually, your plan stops helping you with any prescription drug costs you incur after this point. Once you reach $4,550 in prescription drug costs with your own money, your plan will start helping you again. This can be a burden for many seniors on a fixed income and with chronic health problems. The government has partly solved this problem by offering a 50 percent discount to all seniors who are in the gap.