medicare

Eight Things Medicare Doesn’t Pay For

AnnaMarie Morrow, Director of Medicare

Original Medicare (Parts A and B) covers many medical and hospital services. But some of the things it doesn’t cover might surprise you.

Here are eight things Medicare doesn’t pay for.

#1 Opticians and eye exams

While original Medicare does cover ophthalmologic expenses such as cataract surgery, it doesn’t cover routine eye exams, glasses, or contact lenses. Nor do any Medigap plans. Some Medicare Advantage plans cover routine vision care and glasses.  

#2 Hearing aids

Medicare covers ear-related medical conditions, but original Medicare and Medigap plans don’t pay for routine hearing tests or hearing aids.

#3 Dental work

Original Medicare and Medigap policies do not cover dental care such as routine checkups or big-ticket items, including dentures and root canals.  

#4 Overseas care

Medicare usually doesn’t cover health care while you’re traveling outside the United States. There are some rare exceptions on a ship, Alaska to U.S. travel through Canada, and when you live in the U.S., and a foreign hospital is closer to your home than the nearest U.S. hospital.

Some Medigap policies cover emergency overseas medical costs. Most plans have a $50,000 lifetime limit for foreign travel emergencies.  

#5 Cosmetic surgery

Medicare doesn’t generally cover elective surgery such as facelifts or tummy tucks. It will cover cosmetic surgery in the event of an accidental injury or, if needed, after another treatment, such as reconstruction following a mastectomy.  

#6 Chiropractic care

Original Medicare does not cover most chiropractic services or tests that a chiropractor orders, including X-rays. Part B pays for one manual spinal manipulation by a chiropractor to correct a vertebral subluxation. Some Medicare Advantage plans will cover chiropractic services.  

#7 Massage therapy

Original Medicare doesn’t cover massage therapy. When it comes to pain management, Medicare does cover chiropractic care in certain limited circumstances as well as physical and occupational therapy prescribed by a doctor. Some Medicare Advantage plans cover massage therapy.  

#8 Nursing home care

Medicare pays for limited stays in rehab facilities – for example if you have hip replacement and need inpatient physical therapy for several weeks. But if you become so frail or sick that you must move to an assisted living facility, Medicare won’t cover costs.

Sources: Medicare.govAARP.org


 

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