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5 Things Medicare Does NOT Cover

cosmetic procedure up close 6 Things Medicare Does NOT Cover

Medicare is government-provided health insurance for people who are 65 and older. While it’s a valuable healthcare resource for seniors, it’s important to understand its limitations and the areas where it falls short. By being aware of what Medicare doesn’t cover, you can plan accordingly and explore alternative options to fill those gaps in coverage. Here are 6 things Medicare does not cover.


1. Long-Term Care

nursing home

One of the most significant gaps in Medicare coverage is long-term care. This means that residing in a nursing home or an assisted living facility is not covered. If the possibility of needing long-term care in the future concerns you, then you’ll need to explore other options like long-term care insurance or personal savings.

However, it’s worth noting that in limited circumstances, Medicare will pay for nursing home costs in full if a doctor recommends a short-term stay for medically necessary treatment. Likewise, it will cover limited stays in skilled nursing facilities for specific reasons and only for a short time as well.


2. Dental, Vision, and Hearing Care

man holding a hearing aid

Routine dental care, including cleanings, fillings, and dentures, is not covered by Medicare. Similarly, vision exams, eyeglasses, and hearing aids are also excluded from standard Medicare coverage. For these services, you may want to consider standalone dental, vision, or hearing insurance plans, or explore Medicare Advantage plans that offer additional benefits.

3. Prescription Drugs

prescription drug

Original Medicare does not include prescription drugs. However, you can enroll in a Part D plan to help with the cost of your prescriptions. Also, some Medicare Advantage plans include prescription drug coverage as part of their benefits. When it comes to medications and Medicare, you should always do your due diligence so that you choose the best plan that suits your needs.

4. Oversea Health

senior couple at airport

If you’re planning to travel abroad, you should know that in most cases, Medicare does not cover healthcare services received outside of the United States. However, it may cover emergency care in other countries. If you’re traveling extensively, consider purchasing travel medical insurance.

5. Cosmetic Procedures

senior woman getting cosmetic procedure

Medicare generally does not cover cosmetic procedures, as they are considered elective and not medically necessary. However, it will cover some cosmetic procedures on a limited basis if the treatment is needed because of an injury or if it’s doctor-prescribed to improve the function of a malformed body part. For example, Medicare will pay for some external breast prostheses after a mastectomy.


More Help with Medicare

Medicare Glossary Definition

If you need additional help understanding Medicare, then check out Toni King’s podcast, Medicare Moments.

Click here to download a free copy of the Medicare Prescription Drug Survival Guide.

Originally published May 26, 2023

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