What Might Not Be Covered by Original Medicare?

Medicare
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Original Medicare has limits to what it will cover.

Americans age 65 or older are eligible for Medicare coverage.

Those with certain qualifying disabilities are also eligible for this coverage.

Medicare provides health insurance benefits to these individuals.

According to a recent AARP article titled “7 Things Medicare Doesn’t Cover,” there are certain expenses not included in an original Medicare plan.

Original Medicare will require supplemental plans and alternative means of payment.
Original Medicare plans have limitations.

What are these?

Opticians and eye exams.

Do you require glasses or contacts?

If yes, then you should note the exclusion of contacts, glasses, and routine eye exams from Medicare coverage.

If you have poor eyesight or expect to have worsening vision as you age, you will need to seek coverage elsewhere.

Unfortunately, supplemental Medigap plans from private insurers do not typically cover vision.

Although some Medicare Advantage plans provide vision care as an option, you may want to purchase a separate vision insurance policy for your annual vision needs.

If you require more extreme measures like cataract surgery, original Medicare should provide coverage for these opthalmologic expenses.

Hearing aids.

While some auditory medical conditions are covered by Medicare, both Medigap and the original Medicare do not pay for routine hearing aids and hearing tests.

What can you do?

You may be able to purchase a membership in a discount plan or insurance to cover hearing aids.

Dental care.

Although better oral hygiene has been connected to better health, Medigap and Medicare do not provide coverage for dentures, routine checkups, or root canals.

You may be able to find a Medicare Advantage plan.

Purchasing a dental discount plan or an individual dental plan to supplement original Medicare could also help.

Care When Overseas.

If you incur medical expenses outside of the United States, Medicare Advantage and original Medicare plans will not help.

Some travel insurance policies can cover basic health care coverage.

Another option would be medical evacuation insurance while you are overseas.

This provides the option of being transported to the U.S. or a nearby medical facility in an emergency situation.

Podiatry.

Most problems with your feet, such as callous removal, will not be covered by original Medicare.

If foot exams and treatments are connected to nerve damage from diabetes, Medicare Part B can help.

This can also provide coverage for injuries to your foot.

If Medicare Part B does not help, creating a savings program for these expenses can allow you to set aside funds for these payments.

Cosmetic surgery.

Cosmetic surgery can either be elective or as a result of an injury.

If you injured in an accident and require reconstructive surgery, Medicare will provide coverage for plastic surgery.

You will be responsible for your own bill if you choose elective work like a nose job, tummy tuck, or facelift.

To pay for these, it would be helpful to set aside savings.

Nursing home care.

Long-term living in nursing homes or assisted living facilities is not covered by Medicare.

I know that is a surprise to many folks, often too late to make plans.

If you need to stay in a rehab facility for a few weeks following a hip replacement surgery or other procedure, then that is different.

Original Medicare will provide coverage within strict limits.

If you anticipate needing a nursing home or assisted living facility, purchasing a long-term care policy in advance can help cover such expenses.

Because Medicare has limitations to its coverage, it is wise to plan ahead for these costs.

Reference: AARP (Oct. 1, 2020) “7 Things Medicare Doesn’t Cover”

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