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What Doesn’t Medicare Cover?

Is Forced Medical Treatment Prohibited in Nursing Homes?
Medicare covers the majority of older Americans’ health care needs, from hospital care and doctor visits to lab tests and prescription drugs. Here are some needs that aren’t part of the program — and how you might pay for them.

AARP’s recent article entitled “10 Things Medicare Doesn’t Cover” lists some essential needs for seniors that Medicare doesn’t cover and some ways to pay for them. Beck, Lenox & Stolzer Estate Planning and Elder Law offers this information to keep seniors informed. In many cases, your insurance agent is your best resource to understand how your plan works.

  1. Opticians and eye exams. Original Medicare covers ophthalmologic expenses, such as cataract surgery, However, it doesn’t cover routine eye exams, glasses, or contacts. However, some Medicare Advantage plans cover routine vision care and glasses.
  2. Hearing aids. Medicare covers ear-related medical conditions. However, original Medicare and Medigap plans don’t pay for routine hearing tests or hearing aids. If you are in a Medicare Advantage plan, you might purchase insurance or membership in a discount plan that helps cover the cost of such hearing devices. Some programs also help people with lower incomes to get needed hearing support. You can also pay as you go. Medicare beneficiaries with mild to moderate hearing loss can get hearing aids at drugstores and other retail outlets without a prescription.
  3. Dental work. Original Medicare and Medigap policies don’t cover dental care, such as routine checkups, dentures, and root canals. However, some Medicare Advantage plans offer dental coverage, often as reimbursement plans. If yours does not, or if you opt for original Medicare, get an individual dental insurance or discount plan.
  4. Overseas care. Original Medicare and most Medicare Advantage plans offer little or no coverage for medical costs incurred outside the U.S. Some Medigap policies cover certain overseas medical expenses. If you travel frequently, you might want that. Some travel insurance policies also provide primary health care coverage. Think about medical evacuation (aka medevac) insurance for your adventures abroad.
  5. Podiatry. Routine medical care for feet isn’t covered. However, Medicare Part B covers foot exams or treatment if it’s related to nerve damage because of diabetes or care for foot injuries or ailments. If you face these costs, consider a separate savings program for them.
  6. Cosmetic surgery. This isn’t covered, except for procedures stemming from an accident injury or if it’s required after another treatment. If you face these costs, you also may want to set up a separate savings program for them.
  7. Chiropractic care. Original Medicare doesn’t cover most chiropractic services or the tests that a chiropractor orders, including X-rays. However, Part B will pay for one manual manipulation of the spine to correct vertebral subluxation. In addition, some Medicare Advantage plans will cover chiropractic services, so check with your plan. Chiropractors may also offer payment plans.
  8. Massage therapy. Medicare does cover chiropractic care in certain limited circumstances and physical and occupational therapy when prescribed by a doctor. In addition, some Medicare Advantage plans might cover some massage therapy.
  9. Nursing home care. Medicare pays for limited stays in rehab facilities. It won’t cover your custodial costs if you become so frail or sick that you must move to an assisted living facility or nursing home.
  10. Concierge care. Some physicians and their practices require a membership fee to treat you. These fees vary depending on the practice. Medicare won’t cover this.


Reference: AARP (April 11, 2023) “10 Things Medicare Doesn’t Cover”

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