What Medicare Won’t Cover
Medicare is not FREE. While all those of eligible age are encouraged to investigate and sign-up, please remember: it is not unusual for people on Medicare to spend more than $5,000 a year of their own cash on ongoing health care and insurance costs.
What consumer needs Medicare does not cover? Here are additional costs you might face, and how to pay for them.
- Opticians and eye exams
While Original Medicare does cover ophthalmological expenses such as cataract surgery, it doesn’t cover routine eye exams, glasses or contact lenses. Nor do any Medigap plans. Some Medicare Advantage plans cover routine vision care and glasses. For some people, it makes sense to buy a vision insurance policy for a few hundred dollars a year, to defray the costs of glasses or contact lenses.
- Hearing aids
Medicare covers ear-related medical conditions, but Original Medicare and Medigap plans don’t pay for routine hearing tests or aids. So, if you are in a Medicare Advantage plan, check your policy to see if it covers hearing-related needs. If it doesn’t, or if you have Original Medicare, consider buying insurance or a membership in a discount plan that helps cover the cost of hearing aids. Also, some programs help people with lower incomes get needed hearing support. Or you can pay as you go.
- Dental work
Original Medicare and Medigap policies do not cover dental care such as routine checkups or big-ticket items, including dentures and root canals. Consider buying an individual dental insurance plan or a dental discount plan.
- Overseas care
Original Medicare and most Medicare Advantage plans offer virtually no coverage for medical costs incurred outside the U.S. Some Medigap policies cover certain overseas medical costs. If you travel frequently, you might want a policy that offers this.
- Nursing home care
Medicare pays for limited stays in rehab facilities — for example, if you have a hip replacement and need inpatient physical therapy for several weeks. But if you become so frail or sick that you must move to an assisted living facility or nursing home, Medicare won’t cover your custodial costs. (Nursing homes average about $90,000 a year.) For those with limited income and savings, Medicaid might help fill some coverage gaps.
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John D. Miller is the founder/owner of Home Care Partners, LLC, a Massachusetts business providing private duty, personalized in-home assistance and companion care services to those needing help in daily activities and household functions.
Phone: (781) 378-2164