One of our advisors sat down with a client recently who said something we hear all the time: "I thought Medicare covered everything." They'd just enrolled, and the two things bothering them most, a dental crown and new glasses, weren't covered at all.

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Here's the thing. They're far from alone. Medicare covers hospital stays, surgeries, and doctor visits, but it leaves three gaps that catch almost every new enrollee off guard.

Gap 1: Dental Coverage

Medicare does not cover routine dental care. No cleanings, no fillings, no crowns. As one client told us, "You bite down wrong on an apple, and you need a crown." That crown? You're paying out of pocket unless you have a separate dental plan.

Standalone dental plans exist, but they vary widely. Some are worth the premium. Others charge you more in monthly payments than you'd ever get back in benefits. That's worth shopping carefully before you sign up for the first plan you find. You can see exactly what Medicare does and doesn't cover for dental at medicare.gov.

Gap 2: Vision Coverage

Routine eye exams and glasses aren't covered by Original Medicare either. Medicare will cover eye care tied to a medical condition (like glaucoma or cataracts), but a new prescription for your reading glasses? That's on you.

But that's not the whole story. Some Medicare Advantage plans bundle dental and vision, which sounds convenient. The trade-off is narrower doctor networks. If keeping your current doctors matters to you, and it matters to almost everyone we talk to, a Medicare Supplement plan paired with separate dental and vision coverage might be a better fit.

Gap 3: The IRMAA Surcharge

Now here's where it gets interesting. If your income is above a certain threshold, Medicare charges you more. It's called IRMAA (Income-Related Monthly Adjustment Amount), and it applies to both your Part B and Part D premiums.

The catch: IRMAA is based on your tax return from two years ago. A one-time income event, like selling a property or taking a large distribution, can bump your premiums up two years later. Most people don't see it coming until they open the letter from Social Security.

If you've had a life-changing event (retirement, divorce, loss of a spouse) that lowered your income since then, you can appeal. Visit ssa.gov and search for Form SSA-44, or ask your advisor to walk you through it.

What to Do About It

Think about that for a minute. Three major coverage gaps, and most people don't find out about them until they're already enrolled. Here's what you can do right now:

Review what Medicare actually covers for your situation using the plan comparison tool at medicare.gov/plan-compare.
Compare standalone dental and vision plans in your zip code. Don't assume the first option is the best deal.
Check whether a spouse's employer or retiree plan already covers dental and vision. Sometimes the best option is one you already have.
Before making any big financial moves, ask how it might affect your IRMAA two years down the road.

I wrote Medicare Made 123Easy because this stuff shouldn't be this hard to figure out. But even with the book, sometimes you just want someone to sit down and walk through your specific situation.

That's exactly what we do at American Retirement Advisors. We review your coverage, compare every option in your area, and handle the paperwork, all at no cost to you. Give us a call. No pressure, no pitch. Just a conversation.

Easy Eddie's Take

Here's what I tell folks who are new to Medicare: it's great coverage, but it's got some holes. The big three? Dental, vision, and that sneaky IRMAA surcharge.

Dental and vision aren't part of Original Medicare. You'll need separate plans for those, or you can look at Medicare Advantage (but read the fine print on doctor networks first). And if you had a big income year, like selling a house, your Medicare premiums might jump two years later. That's IRMAA. The good news? You can appeal it if your situation changed.

Quick tip: before you buy a standalone dental plan, check if your spouse's plan already covers you. One of our clients almost doubled up before realizing they were already covered. Saved them a nice chunk of change every month.

Bottom line: Medicare's a good deal, but you've got to fill in the gaps. That's what American Retirement Advisors does, at no cost to you.

Disclaimer: This article is for educational purposes only. It is not sponsored, endorsed, or otherwise representative of Medicare or the federal Medicare program. American Retirement Advisors is not a government agency. For official Medicare information, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).