Medicare is a federally funded health insurance program that provides coverage to individuals who are 65 or older or those with certain disabilities. While this program covers a broad array of healthcare services, it's important to note that not all health-related costs are covered under Medicare. Understanding the exclusions can help individuals plan for their healthcare needs, particularly those approaching retirement age. This article provides an overview of six key areas that Medicare does not cover.
Long-term Care
One significant area not covered by Medicare is long-term care. This includes services such as nursing home care, assisted living facilities, and home care for activities of daily living like bathing, eating, or dressing. While Medicare Part A covers skilled nursing care in a facility following a hospital stay, it does not cover custodial or non-skilled care that makes up the majority of long-term care needs.
Dental Care
Routine dental care, including oral exams, cleanings, fillings, dentures, and most tooth extractions, is not covered by Medicare. Some Medicare Advantage Plans may offer limited dental coverage, but these are not standard with original Medicare. Individuals are encouraged to seek private dental insurance or pay out-of-pocket for these services.
Vision Care
Vision care, including routine eye exams and eyeglasses, is another area that Medicare does not cover. Similar to dental care, some Medicare Advantage Plans offer vision coverage. However, original Medicare only covers specific eye health services or surgeries, not routine vision care.
Hearing Aids
Hearing aids and exams for fitting them are not covered by Medicare. Although hearing loss is common among older adults, beneficiaries must seek alternative funding sources for these devices. Some Medicare Advantage Plans or private insurance companies may offer coverage for hearing aids.
Cosmetic Surgery
Medicare does not cover cosmetic surgery unless it is needed because of an injury or illness. Procedures such as facelifts, liposuction, rhinoplasty, and others are considered elective and thus not covered. However, some reconstructive surgeries, like breast reconstruction following mastectomy, may be covered.
Acupuncture
While Medicare has been expanding its coverage to include more alternative therapies, acupuncture is generally not covered. The only exception is for those with chronic low back pain, as recently updated by the Centers for Medicare and Medicaid Services.