Discovering the limits of Part A and Part B Medicare, or Original Medicare coverage is essential when planning for your present and future healthcare needs. Although Medicare covers a broad range of health services, there are several crucial exclusions, such as dental and vision care.
In this guide, we’ll delve into these gaps in coverage to help you better understand what to expect from Medicare while also exploring supplementary options to fill these voids.
By familiarising yourself with your existing policies’ restrictions and learning how you can supplement them with additional insurance or resources, you can safeguard your health and well-being without facing unexpected financial burdens that could severely affect your family.
While Part A and Part B Medicare covers a wide range of things, it doesn’t cover everything. Here are 7 things Original Medicare doesn’t cover and what you can do to supplement care.
1. Medicare does not cover most dental care
Dental health is a crucial aspect of overall wellness, but unfortunately, most dental care services are not covered by Original Medicare. This lack of coverage extends to routine check-ups, cleanings, fillings, extractions, root canals, dentures, and other essential dental procedures.
Americans have the choice to seek out stand-alone dental insurance plans or sign up for a Medicare Advantage plan with dental benefits. To apply for a Medicare Advantage plan, you need to have Original Medicare. There’s no Medicare prerequisite for private dental insurance.
2. Medicare does not cover long-term care
Medicare’s coverage restrictions include a general lack of benefits for nursing home stays or in-home care lasting more than a short-term basis. This kind of support often plays a crucial role in maintaining one’s independence and ensuring the quality of life as we age or become dependent.
However, if you’re interested in extending your short-term care coverage, you can check out Medigap plan comparison and advice at Medigap Seminars. But if you want to extend into long-term care, you’ll need to invest in long-term care insurance or be qualified under Medicaid.
3. Medicare does not cover eye exams
Original Medicare does not cover routine eye exams, glasses, or contact lenses for individuals without specific medical conditions. Without vision care coverage, you could be vulnerable to undiagnosed issues affecting your eyesight or forced to pay significant out-of-pocket costs.
To ensure you’re covered for eye exams, you’ll need to enroll in a stand-alone vision insurance plan or upgrade to Medicare Advantage. Keep in mind that most insurance plans only cover annual eye exams, glasses up to a certain dollar amount, and contacts with a non-astigmatism.
4. Medicare does not cover routine physical exams
Routine physical exams play a vital role in preventive medicine and maintaining a high standard of overall health. However, Medicare coverage for these important medical check-ups is relatively limited, leaving you responsible for certain costs, although most preventive screening is covered.
With that said, comprehensive routine physical examinations aren’t covered. To prevent unexpected costs and ensure access to crucial wellness services not covered by Original Medicare, sign up for a Medigap plan or consider upgrading to a Medicare Advantage plan.
5. Medicare does not cover cosmetic surgery
Cosmetic surgery refers to elective procedures performed to enhance one’s appearance. While these surgeries can have profound positive effects on a person’s self-esteem and quality of life, they aren’t covered by Medicare unless deemed medically necessary as a result of an injury.
Unfortunately, there aren’t a lot of options for cosmetic surgery coverage, but that doesn’t mean you’re out of luck. Some companies will offer private insurance for those looking to explore cosmetic surgery. But besides that, you may need to rely on building up your savings.
6. Medicare does not cover massage therapy
Massage therapy is a popular complementary health service with numerous potential benefits, including pain relief, stress reduction, and improved muscle relaxation. But unfortunately, such treatments are not considered medically necessary and aren’t included in Original Medicare.
Unlike cosmetic surgery, it’s possible to cover massage therapy through insurance. Whether you’re looking for a private insurance plan or to upgrade to Medicare Advantage, you have options. Once you’re insured, you’re often covered for chiropractic or physical therapy treatment.
7. Medicare does not cover hearing aids
Maintaining optimal hearing ability is essential to our overall quality of life. But as you may have guessed, Original Medicare doesn’t cover hearing aids and routine hearing exams. What’s more, Medicare won’t cover any exams for fitting them, meaning you’ll have to pay out of pocket.
Fortunately, the right Medicare Advantage plan that includes provisions for hearing exams and hearing aids can cover you. If you’re not interested in upgrading, you could try getting a private insurance policy. Some resources may give you access to free or low-cost hearing devices.
Medicare also doesn’t cover concierge care (also known as boutique medicine or direct care) and covered items or services you can get from another provider or an opt-out doctor.
Tim Williamson, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.
