7 Things That Medicare Does Not Cover

7 Things That Medicare Does Not Cover

As you reach your senior years, you will need to learn about the government benefits that are available to you. In terms of medical care, Medicare is a federally-funded program that provides seniors 65 and older with healthcare coverage. It also provides coverage for disabled individuals and those with end-stage renal or kidney failure. However, this type of health insurance won’t cover everything, so it’s important to review what care isn’t covered under a standard Medicare policy:

1. Hearing aids

Medicare does not provide coverage for hearing aids or the fitting exams required for wearing a hearing aid. All of these services must be paid out-of-pocket. However, if you obtain a Medicare Advantage Plan (Part C), extra coverage for hearing, vision, and other types of supplemental care is provided.

2. Routine dental exams

Medicare does not provide coverage for any type of dental care in which the primary reason for the care is to maintain the health of your teeth. The only exceptions are cases in which a dental cleaning is required in preparation for another Medicare-covered procedure. This includes surgical procedures, reconstructive facial surgery after removing a tumor, and oral exams prior to treating fractures in the jaw or bones of the face.

3. Dentures

Since dentures are considered to be a part of oral health care, they are also not covered in a basic Medicare plan. As previously mentioned, participating in a Medicare Advantage Plan will help you get comprehensive dental coverage. Be sure to review what types of dental care are covered to ensure dental implants, dentures, and similar services will be covered.

4. Routine eye exams

While Medicare won’t cover a routine eye exam, the cost of the exam is covered if you need it to diagnose a potential vision problem. Even if it turns out there isn’t a medical reason for your vision difficulties, that exam will be covered. Additionally, you may be covered for eyeglasses or contact lenses only when you have had cataract surgery. Customized eyewear might also be covered if there’s a medical reason that you need tinted lenses or other forms of customization. Surgical procedures to correct your vision will also be covered. A common example is cataract surgery in which your eye’s lens is replaced with an artificial lens.

5. Overseas health care

In most cases, Medicare will not cover your medical care outside the United States. For these purposes, Puerto Rico, Hawaii, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands are acknowledged as being within the U.S. If you are on a cruise ship and the ship’s doctor is legally licensed to practice medicine in the United States, you may be covered for some types of medical care. You may also be covered if the ship is less than six hours from a U.S. port. You may also be covered if you’re traveling back to the U.S. via the most direct route and a foreign hospital is closer than a U.S. hospital. For any other situation, it’s best to obtain travel insurance ahead of time.

6. Long term care

If you have a chronic condition or suffer from general health decline that requires custodial care, Medicare will not cover these expenses. You may need to seek enrollment in a different type of long-term care policy that will cover nursing home stays, extended in-home care, and similar services. Otherwise, these services must be paid out-of-pocket.

7. Prescription drugs

The basic Medicare plan does not cover prescription drug costs. However, participating in Medicare Plan D or a Medicare Advantage Plan will provide you with prescription drug coverage. It’s important to explore what drugs are covered in each supplemental plan since coverage varies by the plan and by location.