FAQ: What Medicare Does Not Cover
Medicare is a federal health insurance program for Americans over the age of 65. It also covers some people under the age of 65 if they have specific disabilities. There are three parts of medicare: Part A which covers hospital stays, Part B which covers different doctor services, and Part D that covers the cost of prescription drugs and some vaccines. You can find out more about medicare and enroll in it through private healthcare companies such as Humana, or Blue Cross Blue Shield. Read on to find out more about what Medicare does not cover:
1. Routine eye exams
Unfortunately, Medicare does not cover the cost of eye exams for eyeglasses or contact lenses. This means you have to pay 100% of the costs of a routine eye exam. However, if you have diabetes or are at high risk for glaucoma then Medicare will cover routine eye exams by a state-authorized doctor. Also, if you have certain chronic eye conditions such as glaucoma or cataracts Medicare may cover the cost of any surgeries, eyeglasses or contact lenses, or diagnostic eye exams.
2. Hearing aids
Medicare does not cover hearing aids or exams for fitting hearing aids. Occasionally, Medicare will cover the cost of diagnostic hearing tests but only if it is recommended by your primary care doctor or another physician to see if you need treatment. The explanation for why they do not cover hearing aids is under the premise that they are routinely needed and low in cost, meaning it is expected consumers will pay for them.
3. Routine dental exams
While Medicare Part A does cover the cost of hospital stays that might be caused by emergency dental issues, Medicare does not cover most dental care costs. This includes procedures and supplies like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. This is because Medicare has changed very little since it was started in 1965 and a push to start including dental care would be costly.
4. Long term care
Long-term care is a range of services and support for your personal care needs that might be required for those with specific chronic illnesses or disabilities. Most long-term care helps with basic personal tasks of everyday life including things like dressing, bathing and using the bathroom. You can get long-term care at home, in the community, in an assisted living facility, or in a nursing home. However, most of these services will not be covered by Medicare.
5. Prescription drugs
While Medicare doesn’t cover prescription drugs in its basic plans it fortunately does provide optional prescription drug coverage to everyone who qualifies for Medicare. However since it is optional, you will need to opt in to it and pay extra. You must have Medicare Part A and Part B to join a Medicare Advantage Plan, and only some of these plans offer drug coverage.
6. Dentures
As mentioned before, Medicare does not cover dental care and unfortunately dental devices such as dentures are not covered either. The cost of dentures varies widely based on the material, type of dentures, and where you live so it’s best to look into finding a good deal when getting dentures.
7. Overseas health care
In most situations, Medicare won’t pay for health care or supplies you get outside of the United States. However, there are three exceptions to this rule, they are as follows: If you’re in the U.S. and have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital that can treat you, if you’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital, or if you live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether it’s an emergency.