Understanding Medicare gaps
Medicare goes a long way to helping seniors manage their healthcare, but it doesn’t cover all possible health care costs.
Knowing what is not covered can help seniors plan ahead before the need for an uncovered type of care arises. This knowledge acts as an essential tool for comprehensive financial planning and well-being.
HEARING AIDS
Medicare typically does not cover hearing aids or routine hearing exams, leaving many seniors to bear the full cost of these essential devices. To address this gap, seniors may explore alternative options such as purchasing supplemental insurance plans that offer hearing aid coverage or researching community programs that provide financial assistance for hearing aids.
EYE EXAMS
Routine eye exams, eyeglasses and contact lenses are not covered by Medicare, except in certain circumstances such as diabetic eye exams or cataract surgery. Seniors can consider enrolling in vision insurance plans or exploring discounted vision programs offered by organizations like AARP to help offset the cost of eye care services.
DENTAL WORK
Medicare does not cover most dental procedures, including routine cleanings, fillings and dentures. Seniors may need to purchase separate dental insurance plans or seek out low-cost dental clinics and discount programs to access affordable dental care. Some Medicare Advantage plans offer limited dental coverage as an added benefit.
OVERSEAS CARE
Medicare typically does not cover health care services received outside of the United States, except in rare emergency situations or specific circumstances. Seniors who travel frequently or reside part-time in other countries may need to consider purchasing travel insurance or international health insurance to cover medical expenses abroad.
PODIATRY SERVICES
While Medicare covers certain services related to the treatment of foot conditions, routine foot care such as nail trimming and callus removal is generally not covered.
Seniors can explore options such as Medicare Advantage plans that offer additional podiatry coverage or seek out community health clinics for affordable foot care services.
COSMETIC SURGERY
Medicare does not cover elective cosmetic procedures or surgeries performed solely for aesthetic purposes. Seniors interested in cosmetic treatments may need to explore private financing options or consider alternative non-surgical cosmetic procedures that are not covered by insurance.
CHIROPRACTIC CARE
While Medicare covers spinal manipulation and other chiropractic services for certain medical conditions, it does not provide comprehensive coverage for ongoing chiropractic care. Seniors may need to explore supplemental insurance plans or pay out-of-pocket for chiropractic services not covered by Medicare.
MASSAGE THERAPY
Medicare does not typically cover massage therapy for general relaxation or wellness purposes. Seniors interested in massage therapy may consider seeking out practitioners who offer discounted rates for seniors or exploring alternative therapies covered by Medicare, such as physical therapy or acupuncture.
NURSING HOME CARE
While Medicare may cover short-term skilled nursing care in a nursing home or rehab center following a hospital stay, it does not provide long-term coverage for custodial care or assisted living expenses. Seniors may need to explore long-term care insurance options or Medicaid eligibility for assistance with nursing home costs.
CONCIERGE CARE
Medicare does not cover concierge or boutique health care services that offer enhanced access to personalized medical care for a fee. Seniors interested in concierge care may need to consider private payment arrangements or explore membership-based primary care practices that offer affordable alternatives to traditional fee-for-service models.