What Does Medicare Not Cover?

Medicare is a government health insurance program in the United States that provides coverage for eligible individuals 65 years or older and those with specific disabilities or medical conditions. However, even though Medicare is an essential program, it does not cover everything.

There are several health services and items that Medicare does not cover, and it is crucial to understand what they are to avoid being caught off guard by unexpected medical bills. Here are some of the things that Medicare does not cover:

Long-term care

Medicare does not cover long-term care or custodial care, which involves assisting with daily activities like bathing, dressing, and eating. If you require long-term care, you must pay for it out of pocket, through Medicaid if you meet certain income requirements, or through a long-term care insurance policy.

Adriana Bellet/ NBC News | From preventive care to hospital stays, Medicare has you covered

Routine dental care

Primary dental care, such as cleanings, fillings, and extractions, is not covered by Medicare. Some Medicare Advantage plans may offer dental coverage, but it is typically limited.

Vision Care

Medicare does not cover routine eye exams, eyeglasses, and contact lenses. However, Medicare Part B does cover an annual eye exam for people with diabetes, glaucoma, as well as certain eye conditions and diseases.

Hearing Aids

Medicare does not cover hearing aids or exams for fitting them, except in very limited circumstances.

Cosmetic Surgery

Procedures solely for cosmetic purposes are not covered by Medicare, except in cases where they are necessary for treating a medical condition.

MH Illustration/ iStock | For most seniors, medicare is their only form of healthcare

Acupuncture

While acupuncture is becoming increasingly popular as a complementary medical treatment, Medicare does not cover it, except in certain limited circumstances.

Prescription Drugs

While Medicare does offer prescription drug coverage through Part D, it does not cover all medications. Some drugs may not be covered; others may have limited coverage or require prior authorization.

Prescription Drugs

While Medicare does cover some prescription drugs, not all drugs are covered. Medicare Part D plans vary in the drugs they cover, and not all plans cover all drugs.

Medical Care Outside of the United States

Medicare generally does not cover medical care received outside of the United States, except in very limited circumstances.

Medical Marijuana

Despite being legalized in many states, medical marijuana is still not covered by Medicare as the Federal Drug Administration does not approve it.

Routine Foot Care

Medicare does not cover routine foot care such as nail trimming, callus removal, or foot massages unless you have certain medical conditions such as diabetes.

Helen Dickinson/ Getty Images | More than 64.5 million Americans were enrolled in Medicare going into 2023

Orthopedic Shoes

Medicare does not cover the cost of orthopedic shoes or other foot care services, such as custom-made shoe inserts or nail care.

Experimental or Investigational Treatments

Medicare does not cover the cost of experimental or investigational treatments that the FDA has not approved. This includes procedures such as stem cell therapy or experimental cancer treatments.

It is essential to remember that just because Medicare does not cover a service or item does not mean you cannot receive it. However, you must pay for it out of pocket or through a private insurance plan.