Medicare provides affordable health insurance for Americans aged 65 and older, as well as a full range of healthcare services that include annual wellness checkups, routine vaccinations, and cancer screenings. However, though Medicare may significantly lower healthcare costs for many Americans, this federal program doesn’t cover all medical-related expenses.
Knowing what is and what isn’t covered by Medicare can help you and your family save and plan ahead for illnesses and circumstances that may require you to pay out of pocket. Here’s a look at 10 medical expenses that Medicare does not cover, along with alternative options to consider if you do need to pay for these costs.
Medical Care in Other Countries
If you plan on traveling the globe after retirement, understand that Medicare does not provide coverage for medical care you receive in another country, including prescription drug costs. This may be worrisome if you have a chronic condition that requires routine care and monitoring, or if you plan on engaging in more vigorous activities such as skiing or horseback riding while on vacation.
However, if you have Original Medicare, you do have the option of purchasing Medigap, which is a type of supplemental Medicare plan available from private insurers that may cover some medical expenses you accrue while traveling outside of the U.S. You can also consider buying travel insurance from a private insurer that covers healthcare expenses while abroad.
Vision Care
Eye exams, eyeglasses, and contact lenses are not covered under Original Medicare unless you have diabetes, in which case your exams and treatment for diabetes-related eye diseases may be covered. If you’re looking for affordable eye and vision care, one way to save money on these expenses is to look for discounted services from big-box retailers such as Walmart and Costco or from eye specialists that offer lower prices for older adults.
Dental Care
All dental services, including cleanings, tooth extraction, and dentures, are not covered by Medicare. However, Part A may cover some dental services you receive in a hospital. Some steps you can take to receive affordable dental care include using a health savings account, visiting a university or college dental school (many of which offer discounted treatment), or seeing a dentist that uses a sliding-scale fee based on your income. Some dentists may even offer you a discount if you pay in cash.
Long-Term Care
Expenses related to long-term care are not covered by Medicare, even if you are living with a chronic condition or disability. Long-term care refers to any care you may need for a long period, such as that provided in a nursing home or assisted-living facility.
Fortunately, Medicaid programs in some states may cover long-term care expenses for those who meet certain health and financial requirements. Other government programs and agencies that may help with long-term care costs include the Program of All-Inclusive Care for the Elderly (PACE), State Health Insurance Assistance Program (SHIP), and the U.S. Department of Veterans Affairs (VA).
Foot Care
Foot conditions are common in people with diabetes. Many people with diabetes need routine foot care so they can detect wounds early on and receive treatment to reduce their risk of infections. However, only Medicare Part B provides coverage for diabetes-related foot care. You pay 20% of the Medicare-Approved Amount for foot care after meeting the deductible. If you’re living with diabetes, work closely with your doctor to manage your condition as best as possible so you can reduce your risk of developing related foot problems.
Hearing Aids
Medicare does not cover the cost of hearing aids or exams during which you’re fitted for hearing aids. If you need hearing aids and rely on Medicare, look for audiologists or ear specialists that offer special discount programs for seniors or that base costs on your income level. Also, ask your doctor about non-profit programs that provide financial assistance, or check with your state’s Medicaid program for more details.
Chiropractic Services
The only chiropractic service covered by Medicare (Part B) is manual manipulation of the spine to correct a vertebral subluxation, which occurs when the bones in your spine become misaligned or mildly dislocated. You’ll pay 20% of the cost after meeting your deductible.
Many chiropractors run their own independent practices. Call around to see if you can find a chiropractor who is willing to agree to an affordable payment plan, especially if you need regular adjustments.
Medicare doesn’t cover any massage therapy services, which means you’ll be responsible for paying 100% of the cost out of pocket. However, it may be helpful to know that many chiropractors also offer massage therapy, which means it’s possible you could bundle this treatment with other chiropractic services.
Acupuncture
Acupuncture is covered by Medicare Part B, but only if you’re diagnosed with chronic low back pain. If you have this condition and opt for acupuncture treatment, Medicare will cover up to 12 visits in 90 days. If your symptoms improve, Medicare will cover an additional eight treatment sessions, for a maximum of 20 visits within a 12-month period.
If you need acupuncture for any other condition, look for providers (including chiropractors) that are willing to bundle this treatment with other services or that offer special discounts or sliding-scale fees based on income.
Resource Links
“Learn what Medigap Covers” via Medicare.gov
“Costs” via Medicare.gov
“Dental services” via Medicare.gov
“Long-term care” via Medicare.gov
“Paying for Long-Term Care” via National Institutes of Health
“Diabetes & Foot Problems” via National Institutes of Health
“Diabetes Prevalence and Incidence Among Medicare Beneficiaries — United States, 2001–2015” via Centers for Disease Control and Prevention
“Foot care” via Medicare.gov
“Hearing aids” via Medicare.gov
“Chiropractic services” via Medicare.gov
“Massage therapy” via Medicare.gov
“Acupuncture” via Medicare.gov