5 Things Medicare Doesn’t Cover (And How To Get Them Covered)

It can be pretty surprising to people to find out that certain routine things are not actually covered by Medicare. In this video, I discuss 5 things Medicare doesn’t cover and ways to get coverage or lower the costs.

1. Vision Services

Traditional Medicare will cover cataract surgery or glaucoma treatment, however, it does not cover routine eye exams or glasses/contacts in general. Some Medicare Advantage plans offer vision coverage so you will want to check your current benefits and see if yours offers vision benefits. For some people, it would make sense to buy an individual vision policy to help offset the costs of eye exams or glasses/contacts. Keep in mind most vision policies do have a cap or an annual maximum benefit, which is the total amount a plan will pay per year towards your glasses and contacts. The cap or annual maximum benefit can be around $150 to $200 a year.

2. Hearing Aids

Medicare covers ear-related medical conditions, but Traditional Medicare does not cover routine hearing tests or hearing aids. If you have a Medicare Advantage Plan check your benefits to see if it covers any hearing-related needs. If you don’t get coverage through your Advantage Plan or you have Traditional Medicare you can look at getting a discount plan that may help reduce the costs of your hearing aids.

3. Dental

Medicare does not cover dental exams or dental work. Some Medicare Advantage plans cover dental services, you can purchase a stand-alone dental plan or get onto a dental discount plan.

There are also Dental, Vision, and Hearing Combo plans that are becoming more and more popular to help cover some large expenses related to dental, vision, and hearing.

4. Full Routine Annual Physical Examination

Medicare doesn’t cover a full routine annual physical examination, including bloodwork, instead, they cover a Medicare Wellness Exam, which is a pared-down version of a routine physical exam. In order to avoid unexpected medical bills when you go for your annual check-up, you will want to make sure you are telling your doctor you are needing your “Annual Medicare Wellness Exam” not a full routine physical exam. If you do want to do a full annual physical examination including blood work, you may be responsible for some or all of the cost.

Additionally, the medical community has recently questioned the need for full annual exams, this is due to overtesting, false positives, and unnecessary medical costs.

5. Long-Term Care or Nursing Homes

Medicare doesn’t cover nursing home care or long-term care. Medicare does offer coverage for a limited stay in a skilled nursing facility. However, when you need help with custodial care that will be considered long-term care which is not covered by Medicare or Medicare Advantage plans. Planning for nursing care is a big deal, you may want to look at a long-term care plan. If you are low-income Medicaid will help fill in the gaps.

Figuring out what is and isn’t covered by Medicare can be surprising and tough to find. We help folks daily navigate Medicare. Please reach out to us with any questions or if you need help, we are here to help! Call us at (888) 465-9728 or email me at [email protected].