Growing old comes with its fair share of surprises — some delightful, like grandchildren and senior discounts, and some not so delightful, like unexpected medical expenses. While Medicare is often seen as the go-to safety net for retirees, it has its own set of gaps that can catch you off guard.
Below, we look into 15 things Medicare doesn’t cover, helping you stay ahead of the curve and avoid those “Wait, what?” moments.
1. Glasses
You’d think that after all those years of hard work, Medicare would help you keep an eye on things — literally. But nope, it’s up to you to foot the bill for your spectacles.
Medicare Part A and Part B generally don’t cover routine eye exams, glasses, or contact lens surgery. The only exception is if you’ve had cataract surgery. In that case, Medicare Part B will cover one pair of glasses or contact lenses. But regular vision care? You’re on your own.
The solution is to invest in a Medicare Advantage plan that includes vision coverage or look into separate vision insurance plans.
2. Massage Therapy
When it comes to enjoying your golden years, nothing says relaxation like a good massage. However, Medicare Part A and Part B focus on medical necessities, and while a massage feels amazing and can offer therapeutic benefits, it’s not considered essential healthcare.
Don’t let that stress you out too much, though — some Medicare Advantage plans may offer additional benefits, including massage therapy.
3. Dentistry
Considering how crucial dental health is to your well-being, it’s a bit of a shocker that routine dental services like cleanings, fillings, crowns, and dentures aren’t covered by Medicare Part A or Part B.
Medicare only covers dental services if they are necessary for another covered procedure, like tooth extractions needed before jaw surgery.
4. Prescription Drugs
If you need daily medications to manage chronic conditions or just to stay healthy, you’ll need extra coverage since Medicare Parts A and B don’t cover most prescription medications you take at home.
This is where Medicare Part D comes in. Part D is a separate plan specifically for prescription drugs. However, Part D plans vary widely and cover different drugs. You should choose a plan that fits your specific needs. Your pharmacist may be able to help you choose the best plan based on your medications.
5. Deductibles
Medicare Parts A and B have deductibles, which you must pay out of pocket before Medicare starts covering your medical expenses.
For Medicare Part A, which covers hospital stays, you must pay a deductible for each benefit period. This period starts when you’re admitted and ends after 60 days without hospital care. You can incur hefty bills if you need multiple stays in a year.
There’s an annual deductible for Part B, which covers outpatient care like doctor visits and tests. After you’ve paid this amount, Medicare generally covers 80% of approved services, leaving you to handle the remaining 20% as coinsurance. Supplemental insurance can cover that remaining 20 percent.
6. Hearing Aids
Unfortunately, Medicare doesn’t cover hearing aids or routine hearing exams for most beneficiaries. It’s like they’re saying, “Sorry, we didn’t catch that!”
But there are still options, like Medicare Advantage plans, that can help you tune into the world around you without breaking the bank. Also, look into discount programs or hearing aid manufacturers that offer more affordable options.
7. Long-Term Care
Medicare does not cover long-term care services like nursing home stays, assisted living facilities, or in-home care. So, if you need assistance with daily activities like bathing, dressing, or medication management as you age, you’ll need to use your own money.
To plan for long-term care, consider purchasing long-term care insurance while you’re still healthy and premiums are more affordable. Alternatively, look into institutional Medicaid, which can cover long-term care services for those who meet income and asset eligibility requirements.
8. Overseas Care
Are you thinking of retiring abroad? Medicare might not join you on that adventure. Medicare covers healthcare services within the United States but doesn’t extend its coverage to overseas care.
To conquer this, consider purchasing travel health insurance. This includes coverage for medical emergencies abroad. Such policies can provide peace of mind and financial protection in case of unexpected illnesses or injuries while overseas.
9. Podiatry
Retirement should be a time to put your feet up, but when it comes to podiatry, Medicare may not cover you. To treat pesky foot problems like bunions, corns, or hammertoes, you will have to finance your own care.
However, Medicare Advantage plans may offer additional coverage for podiatry services. Alternatively, consider supplemental insurance like Medigap, which can help cover out-of-pocket costs for podiatric care.
10. Chiropractic Care
Back pain, neck pain, or other musculoskeletal issues may require you to crack your wallet for chiropractic care since Medicare doesn’t cover such issues.
You may need to look into alternative therapies and self-care techniques like yoga, stretching, and ergonomic adjustments. These will help maintain your spinal health and complement your chiropractic treatments.
11. Concierge Care
Concierge care, also known as boutique or retainer medicine, offers personalized healthcare services that focus on convenience and accessibility. However, these services can be relatively expensive, and it seems like Medicare isn’t ready to pay for any VIP treatment.
For those dreaming of having a doctor on speed dial or enjoying same-day appointments without long waiting periods, consider Medicare Advantage plans with additional benefits like telemedicine or enhanced care coordination.
12. Cosmetic Surgery
Cosmetic surgery is not covered by Medicare unless deemed medically necessary. Enhancements like facelifts, breast augmentations, or tummy tucks done for aesthetic reasons are considered elective, meaning Medicare won’t foot the bill.
But this shouldn’t affect your plans. Many cosmetic surgeons offer financing options to help eligible individuals pay their bills. You can also try medical tourism for more affordable options overseas.
13. Personal Comfort Items and Services
Personal comfort items and services like adult diapers are often left off the Medicare coverage menu. While these items and services may improve quality of life, they are usually considered non-medical and not covered.
Treat yourself whenever you can to some self-care splurges. Whether it’s a plush robe or a decent massage, you can enjoy the perks of retirement on your terms.
14. Investigational Devices
Investigational devices, which are medical devices still being tested, have yet to prove their effectiveness and are often left out of Medicare coverage. These devices can be promising, but until they are officially approved and proven effective, Medicare won’t cover them.
Keep an eye on advancements in medical technology, and if you’re eager to try something new, participate in clinical trials.
15. Home Modifications
Home modifications like grab bars or ramps are often overlooked in Medicare coverage. Even if these modifications make your home more accessible and help you maintain your independence and prevent falls, Medicare isn’t ready to pay for them.
If you want to turn your home into a retirement oasis, look into local grant programs or nonprofit organizations that offer assistance with home modifications.
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