5 Things Medicare Won’t Cover

You turn 65, qualify for Medicare, and then home-free, right?

Not really.

Medicare Part A, or original Medicare, and Medicare Part B, or traditional Medicare, will cover many medical expenses for beneficiaries over the age of 65.

Specifically, Medicare Part A is essential hospital insurance and Part B is medical insurance.

Medicare will pay for surgery, inpatient and outpatient hospital care, doctor’s visits, medical supplies, and equipment, preventative services, and hospice care, to name a few.

However Medicare benefits are very exacting in their coverage limits, and there are a lot of things it won’t cover.

Here are five things Medicare won’t cover.

Dental care

Medicare does not cover most routine dental procedures. Over 37 million Medicare beneficiaries don’t have any dental-based benefits or coverage. 

If you need a dental cleaning, tooth extraction, dentures, or a routine dental visit, for example, then, you’re out of luck. Most Medicare beneficiaries who visit a dentist end up paying $900 in additional out-of-pocket expenses. 

There are several Medicare Advantage plans that will pay for dental procedures like X-rays or basic cleanings, but they come with an annual cap.

Long-term nursing and health care

Medicare minimal coverage for the costs of some health and nursing health care benefits like basic nursing care, assistance with dressing, bathing, and basic quality of living assistance activities.

However, the basic annual cost of a private room in a nursing home facility is over $100,000. The cost of a room in an assisted living home is $50,000. And getting a visit from a weekly home health aide is more than $55,000 annually.

Medicare won’t cover the costs of any long-term nursing or health care needs.

Vision care

Some specific kinds of cataract surgery and accompanying annual eye exam checkups for beneficiaries suffering from diabetes may be covered by Medicare.

There are some Medicare Advantage plans that may offer vision care coverage, but they almost always come with an annual cap.

Generally speaking, Medicare does not cover the cost of an eye exam or glasses.

Hearing aids

The average cost of a quality hearing aid unit per ear is $3,000 or more, not to mention the cost of examinations and fitting exams. And Medicare does not cover any of these costs.

A Medicare Advantage plan may cover some of these costs but only with a limiting annual expenses cap. And Medicare Advantage usually covers low-quality and cheaper hearing aid units.

Prescription drugs

Medicare does not cover any payments for prescribed drugs for outpatient care.

Your only recourse is to pay for a Medicare Part D or Medicare Advantage plan out-of-pocket to cover some of these expenses.

Or, self-insure, if you have enough income or  wealth to cover these extra costs.

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