Navigating the ins and outs of Medicare, the United States’ federal health insurance program for individuals aged 65 and over, can be a daunting task. With its many parts, from Part A (Hospital Insurance) and Part B (Medical Insurance) to Part D (Prescription Drug Coverage), it’s crucial to understand what Medicare covers and, perhaps just as importantly, what it doesn’t. In this blog post, we will explore ten significant medical costs not covered by Medicare, shedding light on potential gaps in your healthcare coverage.
10 Medical Costs Not Covered by Medicare
1. Most Dental Care
Routine dental care, including checkups, cleanings, fillings, dentures, and most tooth extractions, are not covered by Medicare. While some Medicare Advantage plans may offer dental coverage, Original Medicare does not. You’ll need to seek separate dental insurance or pay out-of-pocket for these services.
2. Eye Examinations for Prescription Glasses
Original Medicare does not cover routine eye exams for prescription glasses or contact lenses. Some preventive or diagnostic eye services, such as glaucoma tests, are covered, but regular eye check-ups and eyewear are not.
3. Hearing Aids and Exams for Fitting Them
Despite the common need among older adults, Medicare does not cover hearing aids or exams for fitting them. The cost of these services must be paid out-of-pocket unless your Medicare Advantage plan provides additional coverage.
4. Cosmetic Surgery
Medicare does not cover cosmetic surgeries unless they are needed because of accidental injury or to improve the function of a malformed body part. So, procedures like facelifts, liposuction, and other surgeries for aesthetic purposes are not covered.
5. Long-Term Care
If you need long-term care in a nursing home or assisted living facility, Medicare will not cover the costs. It may cover skilled nursing or rehabilitation care if certain criteria are met, but generally, long-term care is not covered.
6. Personal Care
If you need help with personal care, such as bathing, dressing, or using the bathroom, these costs are not covered by Medicare. However, if you qualify for the Medicaid program, some of these services may be covered.
7. Routine Foot Care
Medicare does not generally cover routine foot care, like callus removal, toenail clipping and preventive maintenance. However, it does cover medically necessary podiatric services for foot injuries or diseases.
Despite growing recognition of acupuncture’s potential benefits, Medicare does not currently cover acupuncture. If you choose to pursue this type of treatment, you will need to pay out-of-pocket.
9. Overseas Coverage
In most cases, Medicare will not cover healthcare services you receive while traveling outside the U.S. There are a few exceptions, but generally, international travel health costs will not be covered.
10. Prescription Drugs
Original Medicare does not cover most prescription drugs. However, you can get drug coverage by joining a Medicare Prescription Drug Plan (Part D) or by buying a Medicare Advantage Plan that includes drug coverage.
As you can see, while Medicare provides substantial health coverage, it doesn’t cover everything. Understanding these gaps is crucial when planning for your healthcare needs and budgeting for potential out-of-pocket costs. For some of these services, supplemental coverage options like Medicare Advantage Plans, Medigap, or separate insurance may be worth considering. Always remember to carefully review any insurance plan you’re considering to understand exactly what is and isn’t covered. Your health is invaluable, so taking the time to understand your coverage will serve you well in the long run.
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