When planning for healthcare in retirement, it's essential to understand what Medicare does and does not cover. Medicare, a federal health insurance program for individuals who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease, provides significant assistance with healthcare expenses. However, it does not cover everything. This article outlines seven notable categories of healthcare services and items that Medicare does not typically cover.
Long-term Care
While some may assume that Medicare covers long-term care services, this is not the case. Medicare will cover medically necessary care for up to 100 days, such as skilled nursing or rehabilitation services after a hospital stay. However, it does not cover custodial care - assistance with activities of daily living, like dressing or bathing - if that is the only care you need.
Dental, Vision, and Hearing Services
Another area where Medicare coverage is often lacking is in dental, vision, and hearing services. Routine dental care, including cleanings, fillings, and dentures, is not covered under traditional Medicare. The same goes for routine vision care, including eye exams and eyeglasses. Hearing exams and hearing aids are also not covered.
Cosmetic Surgery
Medicare does not generally cover cosmetic surgery unless it's needed because of another medical condition. For example, it might cover reconstructive surgery after a mastectomy but not a facelift or other purely cosmetic procedures.
Prescription Drugs
Medicare does not automatically cover prescription drugs. For this coverage, you must purchase a separate Part D plan or choose a Medicare Advantage plan that includes drug coverage.
Care Outside the U.S.
If you travel outside the U.S., it's important to know that Medicare will typically not cover your healthcare services. There are a few exceptions, such as when you're on a cruise ship within six hours of a U.S. port or if you're traveling from state to state and the closest hospital to treat you is in a foreign country.
Alternative Therapies
Medicare does not cover alternative therapies such as acupuncture, massage therapy, or chiropractic services, except for certain manual manipulation of the spine to correct a subluxation.
Personal Comfort Items
Items such as bed rails, raised toilet seats, and other home safety items are not covered by Medicare. These are considered personal comfort items and not medically necessary.