Developed by Ryan Riggins: Senior Protection Coordinator, Licensed Real Estate Broker, and Investment Strategist

Free Medicare Gap Analyzer: See What Medicare Doesn't Cover

If your parent is on Medicare, there are big things it doesn't cover. Long-term custodial care. Most dental, vision, and hearing. 24/7 in-home care. Assisted living entirely. This free Medicare gap analyzer takes 3 minutes. It shows you exactly what your parent's specific Medicare plan does and doesn't cover, plus the dollar amounts Medicare-only families typically face. No email, no signup, no sales pitch.

What's Missing from Medicare?
Check each service your family needs. Medicare Parts A & B do not cover these — you pay 100% out of pocket.
Long-Term Care (Assisted Living / Nursing Home)
Medicare does NOT pay for custodial care — only skilled nursing for limited periods
$60K–$100K+
Adjust to match your local market rates:
$80,000
Routine Dental Care (Dentures / Implants)
Original Medicare covers zero routine dental — no cleanings, fillings, or dentures
$500–$2,000
$1,200
Vision Care (Exams / Glasses)
Medicare covers cataract surgery but not routine eye exams, frames, or lenses
$300–$1,000
$600
Hearing Aids & Fittings
Medicare covers diagnostic hearing tests but NOT hearing aids — the #1 unfunded need
$1,000–$6,000
$3,500
Prescription Drugs (if no Part D)
Without Part D enrollment, you pay full retail for every prescription
$3,000–$5,000
$4,000
Part B Coinsurance Gap
Medicare Part B covers 80% of outpatient/doctor services. You pay the other 20% — with no cap.
$
Your 20% Gap Responsibility: $3,000 /year
⚠️ Unlike most private insurance, Original Medicare has NO out-of-pocket maximum. You are responsible for 20% of every bill, forever, unless you have a Medigap supplement.
Total Estimated Annual Gap
$0
per year in uncovered costs
Monthly Savings Needed: $0
Your Gap Breakdown
🔧 Ryan's Insight
"In my 8 years of guiding transitions, I've seen 'Dental and Hearing' gaps drain a $50K emergency fund in just two years. A $3,500 pair of hearing aids plus $1,200 in dental work every year adds up to nearly $10,000 before you even touch a major medical bill. Don't let these small gaps sink your big plan."
— Ryan Riggins, Senior Protection Coordinator

Medicare gaps are just one piece of the puzzle. The Senior Transition Blueprint covers Medicare, Medicaid, estate planning, home sale strategies, and 16 more critical modules.

📋 Get the Senior Transition Blueprint — $47 📞 Book a Free Call with Ryan 📖 Not ready? Download the Free Starter Guide 💬 Just Text Ryan — (336) 553-8933

Frequently Asked Questions

About Medicare gaps, what Medicare doesn't cover, and what families typically face out-of-pocket.

What is a Medicare gap?

A Medicare gap refers to the costs and care that traditional Medicare doesn't cover. The biggest gaps are long-term custodial care (bathing, dressing, eating), most dental and vision and hearing, assisted living, memory care, and 24/7 in-home care. Families often discover these gaps only after a parent needs care, when out-of-pocket costs hit $5,000 to $15,000 per month.

Does Medicare cover assisted living?

No. Medicare does not pay for assisted living, ever. It covers limited skilled nursing care after a qualifying hospital stay (capped at 100 days), but custodial care in an assisted living facility is not covered. Medicaid can cover assisted living but only after a 5-year asset look-back and only at facilities that accept Medicaid.

What is the Medicare Part D out-of-pocket cap for 2026?

Starting in 2026, Medicare Part D caps prescription drug out-of-pocket spending at $2,100 per year. AARP estimates about 9 million enrollees will save around $1.5 billion in 2026 because of this change. Hit the cap and the rest of the year is covered.

How do I know if my parent has Medicare Advantage or Original Medicare?

Original Medicare uses red, white, and blue cards from the federal government. Medicare Advantage uses cards from private insurers (UnitedHealthcare, Humana, Aetna, etc.). The difference matters because Medicare Advantage plans often have prior authorization requirements and network restrictions that Original Medicare doesn't.

Who built this Medicare gap analyzer?

Ryan Riggins built this tool based on data from KFF, AARP, and CMS, plus 8+ years of helping families navigate senior housing transitions and Medicare coverage shortfalls. Ryan is a senior transition advisor and former house flipper who switched sides to help families avoid the $50K mistakes most don't see coming.