7 Things Health Insurance Doesn’t Cover

Medicare is a government-run health insurance program that provides coverage for Americans who are 65 and older or have a disability. While Medicare covers a lot of medical expenses, there are certain things that it doesn’t cover—like cosmetic procedures, outpatient prescription drugs, and many new treatments and alternative treatments for chronic conditions, like cancer. Here are seven things that Medicare doesn’t cover:

1. Routine eye exams
Medicare doesn’t cover routine eye exams unless you have diabetes or are at high risk for glaucoma. However, if you need surgery to correct your vision, Medicare will cover it. If you want routine eye exams, you can purchase additional coverage through a Medicare Advantage plan or a private insurer like Kaiser Permanente, Blue Cross Blue Shield, Aetna, Humana, or Cigna

2. Hearing aids
Medicare doesn’t cover hearing aids, exams for fitting hearing aids, or exams for hearing problems. However, Medicare will cover diagnostic hearing and balance exams if your doctor thinks you need them. You can purchase additional coverage for hearing aids through a Medicare Advantage plan or a private insurer

3. Routine dental exams
Medicare doesn’t cover routine dental exams, cleanings, fillings, or extractions. However, Medicare will cover dental services if they are necessary for a covered medical procedure, such as jaw reconstruction after an accident. You can purchase additional coverage for routine dental care through a Medicare Advantage plan or a private insurer

4. Deductibles and coinsurance
Medicare has deductibles and coinsurance that you are responsible for paying. For example, in 2023, the Part A deductible will be $1,572, and the Part B deductible will be $233. You can purchase a Medicare Supplement insurance plan (also known as Medigap) to help cover these costs

5. Long-term care
Medicare doesn’t cover long-term care, such as assisted living or nursing home care. However, Medicare will cover short-term care in a skilled nursing facility if it’s medically necessary after a hospital stay. If you want coverage for long-term care, you can purchase a long-term care insurance policy from a private insurer

6. Prescription drugs
Medicare Part A and Part B don’t cover most prescription drugs. However, you can purchase a Medicare Part D prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage

7. Overseas health care
Medicare doesn’t cover health care outside of the United States, except in limited situations (such as emergencies on a cruise ship). If you’re traveling abroad and want coverage for medical expenses, you can purchase a travel insurance policy that includes medical coverage

It’s important to understand what Medicare does and doesn’t cover, so you can plan for your medical expenses and make informed decisions about additional coverage. While Medicare doesn’t cover things like routine dental exams or hearing aids, you can purchase additional coverage from a private insurer. And while Medicare may not cover new treatments or cosmetic procedures, it does provide coverage for many medically necessary services. If you have questions about what Medicare covers, talk to your doctor or a Medicare specialist.

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