Medicare, the federal health insurance program for people aged 65 and over, and certain younger people with disabilities, is often misunderstood. Many assume that it covers all healthcare needs, but in reality, there are several services and items that it does not cover. This article aims to dispel some common Medicare myths, specifically focusing on five things that are not covered by Medicare.
Long-term Care
One of the most common misconceptions about Medicare is that it covers long-term care facilities, such as nursing homes or assisted living. However, Medicare only covers short-term stays in skilled nursing facilities following a hospital admission of at least three days. It does not cover long-term care or custodial care, which includes help with daily activities like bathing, dressing, and eating. This type of care, often required by seniors with chronic illnesses or disabilities, can be costly and families must seek other resources for funding.
Dental, Vision, and Hearing Services
Routine dental, vision, and hearing services are not covered under traditional Medicare. This includes check-ups, eyeglasses, contact lenses, dentures, and hearing aids. Some Medicare Advantage plans, which are offered by private insurance companies that contract with Medicare, may offer these benefits. However, beneficiaries often have to pay extra for these services, and coverage can vary widely from plan to plan.
Cosmetic Surgery
Cosmetic surgery is another service not covered by Medicare. These procedures are often considered elective and not medically necessary. However, Medicare will cover plastic surgery if it's needed to improve the function of a malformed body part or to repair damage from an injury or a surgery.
Prescription Drugs
Medicare Part A and B do not cover most prescription drugs. To receive coverage for prescription medications, beneficiaries must enroll in a Part D plan or a Medicare Advantage Plan that includes drug coverage. These plans are offered by private insurance companies and come with additional costs.
Travel Outside the U.S.
If a beneficiary travels outside of the United States, they should not expect Medicare to cover their healthcare needs. There are a few exceptions, such as if a beneficiary is on a cruise ship within six hours of a U.S. port, or if they need to be treated in a foreign hospital because it's closer than the nearest U.S. hospital. However, these situations are exceptions rather than the rule.