10 Things Medicare Doesn’t Cover

Article written by Alex Alexandrovich

Medicare acts as a crucial health insurance provider for Americans who are 65 years old and above. It offers extensive coverage, but it also has limitations. There are specific services and items that fall outside Medicare's coverage.

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Being aware of these coverage gaps is vital for planning your healthcare needs. It could also prompt you to consider additional insurance for comprehensive coverage.

1. Opticians and Eye Exams

Medicare does not provide coverage for routine eye examinations or eyeglasses meant for vision correction. There are specific medical circumstances under which it does cover eye exams.

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These include conditions like diabetes. It also covers exams post cataract surgery which involve intraocular lens implants.

Thus, only specific medical situations warrant coverage for eye exams under Medicare.

2. Hearing Aids

Hearing loss is a common issue among the elderly population. However, Medicare does not provide coverage for hearing aids or the exams required for their fitting. This lack of coverage can lead to substantial out-of-pocket costs for seniors.

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The price of hearing aids can reach into the thousands. Therefore, this can be a significant financial burden for many.

3. Dental Work

Medicare typically does not include coverage for the majority of dental care. This includes procedures like cleanings, fillings, and tooth extractions.

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It also does not cover dental appliances such as dentures and dental plates. There are, however, exceptions to this general rule. For instance, Medicare will provide coverage for specific dental services if they are performed while you're hospitalized.

4. Overseas Care

Usually, Medicare does not cover the health care services you receive when you are travelling outside the U.S. This is the general rule, but there are a few uncommon exceptions to it. One of these exceptions applies if you are on a cruise ship.

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Specifically, if the ship is within a six-hour distance from a U.S. port. In such a case, your health care might be covered by Medicare.

5. Podiatry

Medicare's coverage notably has certain restrictions, particularly in the realm of foot care, also known as podiatry services. This implies that all routine procedures associated with foot care are not covered by Medicare.

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Specifically, services such as the elimination of corns and calluses are not included in the coverage. In addition, the trimming of nails is another routine foot care procedure that is not covered. Thus, individuals requiring these services will need to seek alternative methods of payment or insurance.

6. Cosmetic Surgery

Medicare usually does not provide coverage for cosmetic surgery. This involves surgeries performed for beautification purposes. Aesthetic procedures like face lifts and tummy tucks fall under this category.

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Liposuction is another example of such a procedure. These surgeries are considered out-of-pocket expenses, meaning the cost must be borne by the individual.

7. Chiropractic Care

Medicare provides partial coverage for chiropractic services, specifically focusing on manual spinal manipulation to rectify a subluxation. This implies that not all services related to chiropractic care are covered. Therapies often linked with chiropractic treatment, such as massages and acupuncture, are examples of such services.

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These types of treatments do not fall under the coverage of Medicare. Therefore, individuals seeking these services will need to bear the cost themselves, as they are not included in Medicare's coverage.

8. Massage Therapy

Despite the potential advantages that massage therapy can offer for chronic pain management, Medicare does not provide coverage for it. If you are drawn to the idea of massage therapy, be prepared to bear the cost yourself.

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It's not part of the services covered by Medicare. Alternatively, you can explore private insurance plans. Some of them might include coverage for massage therapy.

9. Nursing Home Care

Medicare does not provide coverage for long-term care. This is typically the type of care given in nursing homes. However, Medicare does offer coverage for specific circumstances.

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It covers the costs of skilled nursing or rehabilitation care, but there's a condition. This coverage only applies if the care is required after a stay in the hospital.

10. Concierge Care

Boutique medicine, also referred to as concierge care, is a service that allows patients to have access to their doctors at all times. This means patients can reach out to their doctors 24 hours a day, 7 days a week. They are able to enjoy this level of personalized care by paying a certain fee.

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However, it's important to note that this unique medical service is not included in Medicare coverage. Hence, those under Medicare won't have this type of specialized care covered by their plan.

Conclusion

Medicare is a crucial health insurance resource for millions of Americans, yet it doesn't encompass all medical costs. There are gaps in coverage that one should be mindful of to prevent encountering unexpected medical bills.

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Understanding these coverage limitations is vital. To account for services that Medicare does not cover, you might need to think about securing supplementary insurance policies.

Alternatively, you can opt for self-payment for these specific services.

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