• Ed Van Hal

What Medicare Doesn't Cover

Updated: May 11

Medicare doesn't cover everything. Hearing, vision, and dental are the big coverage gaps.

Vision

For vision, Medicare covers cataract surgery and your first pair of glasses afterward. It does not pay for routine eye examinations, contacts, or regular glasses. Neither does your Medigap plan if you have one.


Hearing

As for hearing, neither Medicare nor supplemental plans cover routine hearing tests or hearing aids.


Dental

Dental coverage is the third big gap in Medicare. It does not cover routine checkups or big-ticket items like dentures or root canals. Surgery to treat jaw fractures, some dental services to prepare for radiation treatment of oral cancer, or an oral exam in a hospital before a kidney transplant are among the few instances when Medicare will say okay.


Coverage Outside the United States

Medicare does not cover most healthcare outside of the U.S. There are some narrow exceptions, such as if you live in the U.S. and need medical attention but a foreign hospital is the nearest facility. Some supplemental or Medigap policies and Medicare Advantage plans have limited coverage for medical costs incurred outside the U.S.


Other Major Items Medicare Doesn't Cover

Medicare will not pay for some elective procedures like cosmetic surgery. You’re also on your own when it comes to routine foot care.

While Medicare does not cover long-term care, there is an exception. If you need rehab after a hospital stay for a stroke, broken hip, or other injury, Medicare will pay for inpatient physical and occupational therapy for 20 days. But if you become so frail or sick that you need round the clock residential nursing home care Medicare doesn’t cover that.


The Good News

Some Medicare Advantage plans, which are private alternatives, do provide vision, hearing, and dental coverage but be sure to check exactly what they pay for. You can also buy stand-alone insurance policies for vision, hearing, and dental needs, and for long-term care.


Ed Van Hal

Van Hal Insurance Services

701-277-5905 | Ed@edinsurance.net


As an independent broker with 35+ years of experience, Ed is committed to providing quality insurance options for both groups and individuals at affordable prices.

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