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5 Things Medicare Doesn't Cover (and How to Get Them Covered)

Updated: Nov 8, 2023

Whether you're approaching the Medicare age of 65 or already signed up, you may think the days of worrying over healthcare costs are over. Unfortunately, that is not the case. Even with Medicare, there are some services and procedures you'll have to pay for out of your own pocket, as Original Medicare (Part A and Part B) doesn't cover them. Let's look at some of the things Medicare doesn't cover and how to cover them.


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Routine Dental Care

Medicare covers some dental services as long as they are part of your hospital stays. For instance, if you have a jaw disease and the treatment involves extracting your teeth, Medicare will kick in. However, it doesn't pay for routine care such as dentures, fillings, X-rays, or cleaning.


What to Do

You can get coverage by buying a Medicare Advantage plan that offers dental benefits. Another alternative is to purchase stand-alone dental coverage or go for a Dental, Vision, and Hearing (DVH) plan that combines dental, vision, and hearing benefits.


Prescription Drugs

Original Medicare doesn't pay for prescription drugs, except in some cases where it covers oral chemotherapy medications.


What to Do

Medicare Part D is available through private insurance companies and can help cover the cost of prescription drugs. Although enrolling in a Part D plan is optional, it's best to sign up when you first become eligible. If you delay without other creditable drug coverage, you may pay a monthly penalty when you sign up later. Besides Part D, some Medicare Advantage plans also help pay for prescription drugs.


Vision

Medicare only covers vision services in cases when they are deemed medically necessary. For instance, Medicare will pay for exams and treatment if you have cataract surgery. It will also pay for eye tests if diabetes is affecting your eyes. However, it doesn't cover routine eye exams, glasses, or contacts.


What to Do

You can buy a Medicare Advantage plan that offers coverage for vision. Also, DVH or stand-alone vision plans help pay for glasses, contacts, or both.


Deductibles and Coinsurance

Although Medicare will cover your hospital and medical expenses, there are still deductibles that you are responsible for. If you're formally hospitalized as an inpatient, you must pay a deductible of $1,600 in 2023. Depending on how long you stay in the hospital, you may also have to pay a coinsurance. For doctor's visits and outpatient services, there's also a 20% coinsurance after you meet your deductible.


What to Do

Medical Supplement, also called Medigap, can help cover some out-of-pocket expenses. They are available through private insurance companies.


Hearing

According to the National Institute on Deafness and Other Communication Disorders, about one in three people between the ages of 65 and 74 has hearing loss. Surprisingly, Medicare doesn't cover hearing exams or aids.


What to Do

You can buy a Medicare Advantage plan that provides hearing benefits. A combined DVH plan also enables you to get coverage for hearing exams and aids. Additionally, you can choose to purchase a stand-alone hearing plan.


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Explore Other Options and Get the Coverage You Need for Optimal Health

Knowing what Medicare doesn't cover will help prevent surprises and encourage you to explore other options that can provide coverage for the health services you need. Speak with one of our independent Medicare agents today to get started.


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