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What Is Not Covered by Medicare? All You Need to Know

What Is Not Covered by Medicare? All You Need to Know
December 3, 2020 Tom Clark

You should be aware that Medicare doesn’t cover everything. Read on to learn what is not covered by Medicare and what you can do about it.

In the United States, more than 44 million people, about 15 percent of the American population, are registered in the Medicare program.

But the real question is, what doesn’t Medicare cover?

For those looking for more information, check out this comprehensive guide on what is not covered by Medicare.

Understanding the Components of Medicare

It’s first important to understand the different components of Medicare. It is comprised of three basic parts:

  1. Medicare Part A
  2. Medicare Part B
  3. Medicare Part D

Medicare Part A has to do with hospital insurance. It covers inpatient hospital visits, basic care in a nursing facility, and certain home health care aspects.

Medicare Part B involves your medical insurance. It’s focused on outpatient care, services from your medical healthcare professional, preventive services, and medical supplies.

Medical Part D covers your prescription drugs, such as the necessary vaccines or shots you may need.

If the basic Medicare plan does not cover your needs, consider exploring the different types of Medicare health plans for more advanced care.

Whether this is a service needed at an assisted-living facility or directly in your home, it isn’t covered by Medicare. This includes options such as Medicare Advantage Plans, Medicare Cost Plans, and Pilot Programs.

Be aware, these plans are offered by a private company.

It Doesn’t Cover Most Dental, Vision, and Hearing Care

If you’re covered by the Medicare program, it’s likely your plan does not cover dental, vision, and hearing care, including cosmetic surgery, dentures, hearing aids, and Eye health exams related to prescribing glasses.

Be sure to consult with your medical healthcare professional and discuss specific procedures beforehand. An uninsured operation or procedure can cost you thousands of dollars out of pocket.

In general, an emergency operation or procedure is covered by Medicare. For more information on the ends and outs of Medicare view this resource here.

Medicare Doesn’t Cover Long-term Care

One of the most common things not covered by Medicare is long-term care, also known as custodial care. This includes services such as:

  • Activities of daily living
  • Dressing
  • Bathing

If you require these services or ones like them, check out the All-Inclusive Care for the Elderly (PACE).

Medicare Doesn’t Cover Most Hospital Observations

If worse comes to worst and you find yourself needing to go to the hospital, be sure to consult with the staff to clarify whether you’ve been admitted or are there for observation.

Medicare Part A covers hospital admissions but doesn’t cover most hospital observations.

What Is Not Covered by Medicare

It can be overwhelming to navigate the world of Medicare and to understand exactly what is not covered by Medicare. Be sure to consult this resource to prepare for otherwise unexpected medical costs.

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