When you think of Medicare, you probably think of medical coverage for seniors. And while that is a critical aspect of Medicare, there are several different parts to the program. Each part covers different services, and some parts have gaps in coverage that you may not be aware of. Below, we look at what isn’t covered by Medicare and dispel some common myths about the program:
1. Routine dental exams and treatment
Medicare coverage doesn’t include routine dental exams, cleanings, fillings, or extractions. There are a few exceptions, however. If you need dental care to have surgery that Medicare covers, then Medicare will also cover the necessary dental care. For example, Medicare will cover the extraction if you need a tooth extraction before heart surgery. Medicare will also cover dental care related to an injury, such as a jaw fracture. But for routine dental care, you’ll have to pay out of pocket or purchase an individual dental insurance plan.
2. Long term care
Medicare coverage does not include long-term care, such as nursing home care. Also, Medicare will not pay for custodial care, which is the kind of care you need when you can no longer take care of yourself. This includes things like help with bathing, dressing, and using the bathroom. Some Medicare Advantage plans offer long-term care coverage, but original Medicare does not. If you need long-term care, you’ll have to purchase a separate long-term care insurance policy.
3. Prescription drugs
Medicare Part A and Part B do not cover prescription drugs. However, there is a separate Medicare prescription drug coverage plan called Medicare Part D. You can enroll in this plan if you have original Medicare or get it through a Medicare Advantage plan that includes drug coverage. Medicare Part D requires you to pay a premium, a deductible and copays for your prescriptions. The exact cost will depend on your chosen plan and your needed medications.
4. Hearing aids
Medicare will not pay for hearing aids or routine hearing exams. However, if you have a medical condition causing your hearing loss, such as Meniere’s disease, Medicare will cover the diagnosis and treatment of that condition. In most cases, you’ll have to pay for hearing aids and exams out of pocket. You may be able to get help from the Veterans Administration if you’re a veteran or from state assistance programs if you have a low income
5. Routine eye exams
Medicare Part A and Part B, the hospital and medical insurance parts of Medicare, do not cover routine eye exams. This includes exams for glasses or contact lenses. The only exception is if you have diabetes and your doctor says that you need a routine eye exam to monitor your condition. Likewise, if you need cataract surgery, Medicare will cover it. But for routine vision care, you’ll have to pay out of pocket or purchase an individual vision insurance plan. Medicare Advantage plans, however, which are an alternative to original Medicare, may offer routine eye exams as part of their benefits.
Some top Medicare plan providers:
1.Aetna
2. United Health Care
3. Blue Cross Blue Shield
4. Cigna
5. Humana
6. Anthem
7. Mutual of Omaha
