What Medicare Does Not Cover Slideshow

Coverage gaps

Many Medicare beneficiaries need glasses, hearing aids and dental work, but Medicare typically won’t pay for any of these services. And if your health deteriorates to the point where you need extensive long-term care, Medicare will pick up the tab for only a very limited amount of time and under specific circumstances. Here’s a look at some commonly needed medical services that Medicare doesn’t pay for.

Dental care

A visit to the dentist for preventive care or treatment for a dental issue won't be covered. Medicare doesn’t pay for routine dental cleanings and fillings. Dentures and other types of dental devices aren’t covered either. Medicare Part A might pay for certain dental services received if you are hospitalized during an emergency.

Hearing aids

Many retirees find it more difficult to hear clearly as they age, especially in noisy settings. Medicare won’t pay for a hearing aid or the exam required to select and fit an appropriate device. However, Medicare could cover a hearing and balance exam if your doctor determines it’s necessary, but a copayment, coinsurance and deductible may apply. Medicare might pay for a surgically implanted device that provides a sense of sound, such as a cochlear implant.

Routine eye examinations

Vision checks for the purpose of prescribing glasses and contact lenses are not covered by Medicare. However, eye exams and tests may be covered by Medicare Part B for people with specific conditions, such as an annual glaucoma test for high-risk retirees, a yearly eye exam for diabetic retinopathy and tests and treatments for age-related macular degeneration. A simple vision test may be provided during your “Welcome to Medicare” preventive care visit during the first 12 months you have Medicare Part B.

Glasses and contacts

Many older people need corrective lenses to see clearly, but Medicare typically doesn’t cover the cost of glasses or contact lenses. However, if you receive cataract surgery that implants an intraocular lens, Medicare covers one pair of eyeglasses or one set of contact lenses provided by a Medicare- approved supplier. Medicare also pays for cataract surgery that is completed with traditional surgical techniques or lasers.

Cosmetic surgery

Medicare won’t cover most types of cosmetic surgery. However, if the surgery is due to an injury or deformity, Medicare might pay for it. For example, Medicare covers the cost of artificial limbs and their replacement parts and artificial eyes. Breast cancer survivors are eligible for a breast prosthesis after a mastectomy.

Routine foot care

Medicare Part B will cover medically necessary podiatrist services for foot injuries, including hammer toes, bunions and heel spurs. However, Medicare doesn't provide routine foot care such as the removal of corns and calluses, nail maintenance or foot cleaning. Foot exams and treatments could be covered for those with diabetes or other specific conditions. For example, Medicare will provide custom-molded shoes and inserts to those with severe diabetic foot disease and orthopedic shoes if they are a necessary part of a leg brace.

Acupuncture

This Chinese medicine procedure involves inserting needles into the skin at specific places on the body and is thought to relieve various ailments. However, Medicare won’t pay for acupuncture treatments. Medicare will cover chiropractor visits for medically necessary manipulation of the spine, but it may not cover other chiropractic services, such as X-rays and massage therapy.

Care received outside the U.S.

Medicare typically won’t cover health care received in another country. However, there are a couple of rare instances when Medicare will pay, such as if a foreign hospital is closer than the nearest U.S. hospital for a beneficiary injured in the U.S. or if you receive emergency medical services in Canada while traveling between Alaska and the continental U.S. Medicare may cover health care services received while on board a ship in U.S. territorial waters.

Personal care

If you need to hire help for bathing, dressing or getting out of bed, Medicare typically won’t cover the cost of personal care services. Medicare also generally doesn’t pay for housekeeping services, such as help with shopping, meals delivered to your home or 24-hour assistance at home. You may be able to receive help with custodial care costs if you qualify for Medicaid or purchase a long-term care insurance policy.

Long-term care

Medicare will pay for a short-term stay at a nursing facility if it follows a hospital stay of three or more days. Benefits might include a semiprivate room, meals and skilled nursing and rehabilitative services, such as intravenous injections or physical therapy. While there’s no cost-sharing requirements for the first 20 days of care, you’ll owe $170.50 per day for days 21 through 100. Medicare won’t pay out benefits for nursing home stays that exceed 100 days.

Medical Services Medicare Does Not Cover

Dental care. Hearing aids. Routine eye examinations. Glasses and contacts. Cosmetic surgery. Routine foot care. Acupuncture. Care received outside the U.S. Personal care. Long-term care.

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