Will Medicare Cover it?
By Daniel Petkevich
Oct 3, 2023
A helpful guide to services excluded by Medicare.
Medicare Part A and Part B cover a wide range of medical services, but certain services and expenses are not covered or only partially covered by these programs. Medicare beneficiaries must understand these limitations and consider additional coverage options like Medicare Supplement Plans (Medigap) or Medicare Advantage plans to help fill the gaps.
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Here are examples of services Medicare will not cover:
Long-term Care: Medicare generally doesn't cover long-term care in nursing homes, assisted living facilities, or custodial home care.
Routine Dental Care: Medicare does not cover cleanings, fillings, and dentures. Some Medicare Advantage plans may offer limited dental coverage.
Vision Care: Routine eye exams for glasses or contact lenses are typically not covered. However, Medicare may cover eye exams related to glaucoma or cataract treatment.
Hearing Aids: Medicare does not cover the cost of hearing aids or routine hearing exams. Some Medicare Advantage plans may provide limited coverage for hearing aids.
Cosmetic/Elective Procedures: If a procedure is not medically necessary, Medicare will not cover it.
Routine Foot Care: Medicare does not cover routine foot care like toenail trimming and callus removal unless it is medically necessary due to certain conditions like diabetes.
Prescription Drugs: While Medicare Part B covers some medications administered in a clinical setting, it does not cover most prescription drugs you would take at home. You'll need a separate Medicare Part D plan for prescription drug coverage.
Treatment Outside the US: Healthcare services received beyond U.S. borders are not covered. Medicare may cover some emergency treatment when the closest hospital is in a foreign country (e.g., Canada or Mexico).
Home Modifications: Home modifications to accommodate disabilities or for safety reasons are typically not covered by Medicare.
Routine Physical Exams & Labs: Medicare does not cover routine physicals or lab work. However, it does cover an annual wellness visit where preventive services like vaccinations and screenings are discussed.
Alternative Medicine: Medicare generally does not cover naturopaths and other alternative medicine practitioners. However, limited acupuncture and chiropractic visits are permitted to treat low back pain.
Custodial Care: Help with activities of daily living (ADLs) like bathing, dressing, and eating, often provided by home health aides, is not covered.
It's essential to review your specific Medicare plan details and consider additional coverage options, such as Medigap or Medicare Advantage plans, to address your individual healthcare needs. These plans can provide coverage for some of the services and expenses not covered by Medicare. Schedule a chat with one of our Medicare experts to discuss coverage by scheduling an appointment at fairsquaremedicare.com
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