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5 things not covered by Medicare

5 things not covered by Medicare

Medicare is invaluable for a large percentage of the country’s population for many reasons. People who are older than 65 can get the full range of cost coverage offered by Medicare Part A and Part B when they sign up for them. However, while Medicare does cover most healthcare expenses one might incur, certain costs are outside coverage boundaries, even for this scheme. Here are some of the things not covered by Medicare:

Long-term care
Long-term care is among the most expensive healthcare services one can use. According to some studies, the median cost of a private room in nursing homes is about $115,000 in 2023. Certain cost estimates state that using a room for a prolonged period with assisted-living facilities costs about $47,000 for 44 hours per week of care given by a home health aide.

While Medicare covers certain skilled nursing services, it does not cover the things included in custodial care, such as dressing, bathing, feeding, and other similar activities involved in daily living. To ease things, people can purchase health insurance externally to cover any possible healthcare requirement that includes long-term care.

Hearing aids
While Medicare does cover the cost of major procedures and treatments done for ear-related health conditions, the cost of routine hearing tests or hearing aids is not a part of the original Medicare and Medigap package. To address this, people having Medicare Advantage (Medicare benefits with select private insurance providers) subscriptions can check their policy if their hearing-related needs are covered through it or not. People with Original Medicare coverage can purchase external health insurance or sign up for a membership to various discount plans that will cover the cost of hearing aid devices.

A particular positive to emerge out of this is that Medicare beneficiaries with mild to moderate hearing loss can purchase hearing aids at pharma stores and retail outlets without the need for a prescription.

Dental work
Medicare does not cover teeth cleanings, denture installations, most tooth extractions, and other activities included in routine dental visits to dentists. Only certain Medicare Advantage plans cover X-rays and basic cleanings. Unfortunately, such plans tend to have an annual coverage cap of $1,500. The workaround in this case for Medicare subscribers is to purchase an external separate dental insurance policy to keep them financially secure in case future dental surgeries are needed in the long term.

Routine vision care
Medicare does not cover the cost of new glasses, contact lenses, or routine eye exams. However, it does cover the cost of major surgeries such as cataract operations or treatments done to optimize eye muscles for vision.

Overseas healthcare
Both Original Medicare and Medicare Advantage offer little to zero coverage for healthcare costs incurred internationally. Therefore, it is imperative for people to check out external travel insurance policies that provide the much-needed coverage. Certain policies cover healthcare-related expenses if they are incurred within the territorial waters belonging to the country. A particularly useful solution is to consider medical evacuation (known as medevac) insurance for such situations. These are low-cost policies that facilitate transportation of unwell individuals from the place they fell sick to nearby health facilities or within the US, where Medicare would activate again for them.