The 3 Gaps Medicare
Doesn't Close
Medicare is excellent coverage — but it was never designed to cover everything. Here are the three biggest financial exposures that catch people off guard, and how to protect yourself from each one.
Guidance from licensed insurance specialist Steve Germain. Serving South Florida families since 2009.
Gap 1 of 3
The 20% Exposure
Original Medicare only covers 80% of your medical bills — with no cap on what you owe.
The Gap
Original Medicare pays 80% of approved medical costs. That leaves you personally responsible for the remaining 20% — with no out-of-pocket maximum. A $100,000 surgery means $20,000 coming out of your pocket.
It Adds Up Fast
Most people assume Medicare will cover most of their medical bills. The reality is that without supplemental coverage, a single hospitalization or serious diagnosis can result in tens of thousands of dollars in out-of-pocket costs.
The Solution
A Medicare Supplement (Medigap) plan or a Medicare Advantage plan with a built-in out-of-pocket maximum can close this gap entirely. We compare your options and find the right fit — at no cost to you.
The Bottom Line: The 20% gap isn't small. Without coverage to close it, one health event can become a financial emergency.
Gap 2 of 3
The Long-Term Care Exposure
Medicare was never designed to pay for extended nursing home or in-home care.
What Medicare Covers
Medicare covers short-term skilled nursing care — typically up to 100 days following a qualifying hospital stay. After that, you're on your own. It does not cover custodial care, assisted living, or long-term in-home care.
The Real Cost
The average cost of a private nursing home room exceeds $100,000 per year. In-home care can run $50,000–$75,000 annually. Without a plan, these costs can wipe out a lifetime of savings in just a few years.
The Solution
Long-term care insurance and hybrid life/LTC products can protect your assets and preserve your options — but they must be put in place before you need them. Learn more about protecting your retirement savings from healthcare costs.
The Bottom Line: Long-term care is the single greatest financial threat to your retirement savings. Planning ahead is the only way to protect against it.
Gap 3 of 3
The Critical Illness Exposure
A cancer, heart attack, or stroke diagnosis brings costs Medicare will never touch.
The Hidden Costs
When a serious diagnosis hits, the medical bills are only part of the story. Travel and lodging for specialist care, home modifications for accessibility, and everyday bills — mortgage, utilities, groceries — don't stop just because you're sick.
The Income Gap
If you or your spouse stop working due to a serious illness, your household income can drop dramatically while your expenses stay the same or increase. Medicare pays the hospital — it doesn't replace your income or cover your life.
The Solution
A critical illness plan pays a tax-free lump sum directly to you upon diagnosis of cancer, heart attack, stroke, or other covered conditions. No restrictions — you use the money however you need to, whether that's treatment, bills, or family support.
The Bottom Line: A health crisis should never become a wealth crisis. A simple, affordable critical illness plan makes sure it doesn't.
The Reality of “The Big 3”
Cancer, heart attack, and stroke are the three most common critical illnesses — and the financial impact goes far beyond what Medicare will ever cover.
Cancer
1 in 2 men and 1 in 3 women will be diagnosed with cancer in their lifetime.
Treatment costs, travel for specialty care, home modifications, and lost income can easily exceed $100,000 — much of it not covered by Medicare.
Heart Attack
Every 40 seconds, someone in America has a heart attack.
Cardiac rehabilitation, follow-up care, medications, and recovery time away from work create financial strain that Medicare only partially addresses.
Stroke
Stroke is a leading cause of long-term disability in the United States.
Long-term rehabilitation, home health aides, and assistive equipment can cost tens of thousands of dollars annually — none of which Medicare covers long-term.
Simple, Affordable Protection
A critical illness plan pays a tax-free lump sum directly to you upon diagnosis. No restrictions — use it for treatment, bills, travel, or anything your family needs. A health crisis should never become a wealth crisis.
No Restrictions
You decide how to spend the benefit — treatment, mortgage, groceries, or anything else.
Immediate Relief
Funds are paid directly to you, not to a hospital or provider.
True Confidence
Know that a diagnosis won't derail your retirement or burden your family.
Free to You · 25+ Carriers · Since 2009
Don't Wait for a Diagnosis to Find Out What You're Missing
We'll review your current coverage, identify your gaps, and show you exactly what it would cost to close them. Most people are surprised by how affordable the protection is.