Uncovering Hidden Costs in Medicare Plans: What You Need to Know

For many seniors, Medicare is meant to be the safety net that ensures healthcare costs remain predictable and affordable in retirement. But too often, what looks like a straightforward plan on paper comes with hidden costs that catch people by surprise. These unexpected expenses can erode retirement savings, limit access to care, and create unnecessary stress.

At National Benefit Plans (NBP), we believe clarity is not optional. We believe it’s essential. By uncovering these hidden costs upfront, we help our clients make confident choices that align with both their health needs and financial realities.

Commonly Overlooked Costs in Medicare Plans

1. Gaps in Original Medicare

Many seniors think that all they need is Original Medicare, but they may not realize the coverage comes with significant gaps.

In reality:

Original Medicare does not include an out-of-pocket maximum, which means there’s no limit to what you could spend on deductibles, coinsurance, and copayments. A long hospital stay or ongoing outpatient care can quickly become expensive.

On top of that, Original Medicare doesn’t cover prescription drugs, routine dental, vision, or hearing services.

Without supplemental coverage, these gaps can leave retirees exposed to high and unpredictable healthcare costs.

2. Out-of-Network Providers

Medicare Advantage plans frequently advertise low monthly premiums, but care from out-of-network providers can result in bills that are far higher than expected.

A study by the Commonwealth Fund found that almost 30% of Medicare Advantage enrollees who sought out-of-network care faced significant out-of-pocket costs.
Source: Commonwealth Fund

3. Skilled Nursing and Rehabilitation Stays

Original Medicare covers up to 20 days in a skilled nursing facility with little cost. But starting on day 21, patients may face $214 per day in 2025 out-of-pocket up to day 100. Members will be responsible for All costs for each day after day 100 of the benefit period.
Source: Medicare.gov

Without supplemental coverage, even a short recovery period can become financially overwhelming.

4. Dental, Vision, and Hearing Care

Original Medicare does not cover routine dental, vision, or hearing care, services that are essential to seniors’ quality of life.

According to KFF, 65% of Medicare beneficiaries had no dental coverage in 2019, leaving many to pay thousands per year out of pocket.
Source: Kaiser Family Foundation

5. Late Enrollment Penalties

Failing to enroll in Medicare Part B or Part D when first eligible can lead to lifetime penalties. For example, the Part B penalty increases premiums by 10% for each 12-month period of delayed enrollment—a cost that compounds over time.
Source: Medicare.gov

The NBP Approach: Transparency First

At NBP, we’ve seen firsthand how hidden costs can derail retirement plans. That’s why our approach is built on transparency and guidance including:

• Personalized Plan Reviews: We evaluate every client’s health needs and financial situation, identifying where hidden costs could arise.
• Clear Explanations: We translate complex Medicare terms into plain language, ensuring no surprises.
• Ongoing Support: Because Medicare rules change annually, we provide consistent reviews to protect clients from creeping costs.

Why Clarity Matters

Healthcare is one of the largest expenses seniors face in retirement, with the average 65-year-old couple projected to spend $315,000 on healthcare over their lifetime.
Source: Fidelity

That number can climb even higher when hidden Medicare costs aren’t factored into the plan.

At NBP, our mission is simple: give clients the clarity they need to make confident decisions. By shining a light on overlooked costs, we help seniors avoid financial pitfalls and focus on what matters most, living fully in retirement with peace of mind.

Would you like  to learn more? Book a free consultation with one of our Medicare agents here.