3 Gaps Medicare Doesn't Cover
A major health event or unexpected life transition comes with costs that go far beyond the medical bill. We’ll help you prepare your holistic plan so you can focus on healing and living, not expenses.
Medical Gap
Your 20% Share
Many are surprised to learn that Original Medicare (Parts A & B) generally pays 80% of approved medical bills, but there is no annual out-of-pocket maximum. If you face a major surgery or treatment, that remaining 20% is not a small number.
Our Approach
We help you put a "stop-loss" in place through a carefully selected Supplement or Advantage plan, giving your financial exposure a firm, predictable ceiling.
Cancer, Heart & Stroke Gap
Protecting Your Family
Medicare is designed to pay your doctors and hospitals, but it wasn't built to cover the financial toll of a major illness. Cancer, Heart Attack, or Stroke often comes with "hidden costs" like travel for specialists, home modifications, and non-medical bills. These fall outside traditional coverage and can quickly drain a retirement nest egg.
Our Approach
We recommend Umbrella Coverage for every client. These plans pay a tax-free cash benefit directly to you, giving you the freedom to focus on healing instead of finances.
Extended Care Gap
Protecting Your Independence
Traditional health plans and Medicare are built for short-term recovery. They are not designed to pay for extended skilled care, ongoing home health aides, or assisted living. For many families, this gap is the single greatest threat to their retirement savings.
Our Approach
We integrate skilled care strategies into your overall plan. Our goal is to ensure your hard-earned assets remain protected and you maintain your independence without burdening your loved ones.
Costs nobody budgets for.
Travel And Lodging
The best specialist for your diagnosis may be in Philadelphia, Pittsburgh, or further. Weeks of driving, parking, hotels and meals, for you and whoever comes along.
Changes At Home
A ramp, a walk-in shower, a bed moved to the first floor. Recovery often means adapting the house before you can come back to it.
The Bills That Don't Pause
Mortgage, utilities, groceries, insurance. They keep schedule whether or not you are able to keep yours.
What It Costs Your Family
A daughter takes unpaid leave. A spouse cuts back to part time. The lost income is real and it rarely gets counted.
Oral Chemotherapy
Chemotherapy taken in pill form runs through your Part D prescription plan rather than Part B, and those drugs can potentially cost you thousands of dollars a month.
Your 20% Share
Original Medicare generally pays 80% of approved costs with no annual out-of-pocket maximum. On a large bill, the remaining 20% is not a small number.
You choose
The benefit amount, based on what a hard year would actually cost your household.
You're paid
On diagnosis of a covered condition. Tax-free in most situations — confirm with your tax advisor.
You decide
Treatment, travel, the mortgage, or hiring help at home. No restrictions.
Worth knowing: this coverage sits alongside your Medicare plan. It doesn't replace anything, doesn't change your doctors, and doesn't affect what your current plan pays.
A lump sum, paid to you, upon diagnosis.
Most people don't know this kind of coverage exists. It's straightforward: you choose the benefit amount up front, and if you're diagnosed with a covered condition, that money is paid directly to you — not to a hospital, not to a network.
There is no itemizing and no receipts. You decide what the money is for.
What Our Clients Have To Say
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