Medicare is a lifeline for millions of Americans, providing essential health coverage for those 65 and older or with certain disabilities. Many people consider it a catch-all solution for their medical needs in retirement. However, some surprising gaps in Medicare coverage can catch beneficiaries off guard and potentially lead to unexpected out-of-pocket expenses.
In this blog post, I highlight 12 things Medicare doesn’t cover. Understanding these gaps is crucial for anyone who relies on Medicare or is approaching eligibility.
Dental care
Medicare doesn’t cover most dental work. This includes routine cleanings, fillings, and even dentures. You’ll need to pay out of pocket for these services or get separate dental insurance. Poor dental health can lead to other health problems, so it’s important to take care of your teeth.
Vision care
Regular eye exams and glasses aren’t covered by Medicare. You’ll have to pay for these yourself unless you have a separate vision plan. Medicare only covers some eye care related to diseases like diabetes or glaucoma. Good vision is important for safety and quality of life as you age.
Hearing aids
Medicare doesn’t pay for hearing aids or fittings, which can be very expensive, often thousands of dollars. Some Medicare Advantage plans might offer hearing aid coverage. Hearing loss can lead to isolation and other health issues, so it’s a serious concern for many older adults.
Long-term care
Medicare doesn’t cover long-term care in nursing homes or assisted living facilities. It only pays for short stays in skilled nursing facilities after a hospital stay. Long-term care can be very expensive and is often needed as people age. It’s important to plan for this possibility.
Cosmetic surgery
Medicare doesn’t pay for cosmetic procedures like facelifts or tummy tucks. It only covers plastic surgery that’s medically necessary, like after an accident or illness. Cosmetic procedures can be very expensive. It’s important to understand the difference between cosmetic and medically necessary surgeries.
Acupuncture
Most acupuncture treatments aren’t covered by Medicare. There’s a limited exception for chronic low back pain. If you want to try acupuncture for other conditions, you’ll need to pay for it yourself. Some people find acupuncture helpful for pain and other issues.
Medical care outside the U.S.
Medicare usually doesn’t cover the healthcare you get while travelling outside the United States. There are a few rare exceptions, like if you’re on a cruise ship near U.S. shores. You might need to buy separate travel insurance if you travel a lot. Getting sick or hurt while abroad can be very expensive without coverage.
Personal care services
Medicare doesn’t pay for help with daily activities like bathing, dressing, or eating. This type of care, often called custodial care, can be expensive. Many older adults need this kind of help as they age. It’s important to plan for these potential costs.
Routine foot care
Basic foot care, like removing calluses or trimming nails, isn’t covered by Medicare. There are exceptions for people with certain health conditions, like diabetes. Foot problems can affect your ability to stay active and independent. Taking care of your feet is important for overall health.
Alternative medicine
Most alternative therapies, like homeopathy or naturopathy, aren’t covered by Medicare. Chiropractic care is only covered in limited situations. If you use these treatments, you’ll need to pay for them yourself. Some people find alternative therapies helpful, but they can be expensive.
Prescription drugs (in some cases)
Original Medicare doesn’t cover most prescription drugs you take at home. You need to join a separate Medicare Part D plan for drug coverage. Some people are surprised by this gap in coverage. Prescription drugs can be very expensive without insurance.
Elective procedures
Medicare doesn’t cover procedures that aren’t medically necessary. This might include things like weight loss surgery if you don’t meet certain health criteria. Elective procedures can be very expensive. It’s essential to understand what Medicare considers medically necessary.
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