What Is Covered And Not Covered By Medicare?

 Medicare provides basic healthcare coverage to adults age 65 and older, but it is far from complete. If you want to rely on Medicare as you age, it's critical to understand what Medicare covers and where it falls short.

Continue reading to learn exactly what Medicare covers and does not cover so you may begin to plan financially or by obtaining extra coverage.

The Cost of Medicare

Medicare provides basic healthcare coverage to adults age 65 and older, but it is far from complete. If you want to rely on Medicare as you age, it's critical to understand what Medicare covers and where it falls short.

Continue reading to learn exactly what Medicare covers and does not cover so you may begin to plan financially or by obtaining extra coverage.

What Does Medicare Not Cover?

Medicare is frequently necessary healthcare for many people, but before joining, it's crucial to understand what Medicare does not cover so that you can start budgeting or look for a plan to complement it (while you're still healthy). Medicare has the following gaps:

  • Routine dental care like teeth cleaning, fillings, x-rays, and more isn’t covered under Medicare. 
  • Long-term care: Having a long-term care plan is essential because Medicare does not cover stays in retirement facilities. While skilled nursing services are often covered, services like assisted dressing, bathing, feeding and more are not.
  • Vision care: Routine vision care like eye exams and prescription glasses is not covered under Medicare.
  • Hearing aids, medical care overseas, prescription drugs (unless you’re enrolled in Part D), dentures, cosmetic surgery, acupuncture, and routine foot care. 

Surprising Services Medicare Does Cover

Medicare has five different parts to it, which gives you options for your coverage. But it also covers certain services you might not have expected, such as:

Part A:

  • Walkers and wheelchairs 
  • Blood transfusions
  • Certain home care services
  • Stays for three consecutive days in a skilled nursing facility (if prescribed by a doctor)

Part B:

  • Screening tests for cancer, diabetes, depression, and more.
  • Ambulance services
  • Certain vaccinations, like influenza and hepatitis,
  • Some medical equipment
  • Supplies for managing diabetes

Medicare can be vital for individuals without healthcare coverage, and these covered services demonstrate why. Without Medicare, these would all have to be paid for out of cash if necessary, which would be difficult for many people (for example, paying for an ambulance journey out of pocket might cost hundreds to thousands of dollars).

The Bottom Line

Medicare is not the most comprehensive healthcare coverage, but it does cover the essentials that many people require. Understanding what Medicare covers and does not cover before enrolling or requiring services will help you be well prepared.


By Allen Sharen | Jul 20 2022

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