Medical Services Medicare Doesn’t Cover

Medicare does cover a lot, but there are several other important expenses that it does not cover such as eye care, dental care and hearing exams and aids, to name a few. Be aware of what is covered and what is not so that you can supplement your insurance as needed to avoid expensive out of pocket costs. Thanks for visiting us at Advocare of South Florida, providing geriatric care management to area families in North Palm Beach, Jupiter, West Palm Beach and Palm Beach Gardens.

While Medicare covers a wealth of preventive and medically necessary doctor’s visits and procedures, there are some common medical services Medicare doesn’t cover or covers only under specific circumstances. “Medicare doesn’t cover eyeglasses, hearing aids or dental benefits,” says Juliette Cubanski, a Medicare policy analyst at the Kaiser Family Foundation. “If you don’t have supplemental coverage, then most people who need those services would end up having to pay out of their own pocket.” Here are some common medical services many older people need that traditional Medicare won’t pay for:

Eye exams. Most Medicare beneficiaries are eligible for a simple vision check at preventive care visits, but Medicare doesn’t cover routine eye exams for eyeglasses or contact lenses. However, some preventive and diagnostic eye care services are available to Medicare Part B recipients, including tests for glaucoma and macular degeneration. And people who have diabetes are eligible for an annual eye exam for diabetic retinopathy.

Eyeglasses. Although huge numbers of seniors need glasses or contacts to see clearly, Medicare typically won’t pay for them. “For the Medicare population, things like eyeglasses are something that most of them are using,” says Allison Hoffman, an assistant professor of law at the UCLA School of Law. “Most people pay for those out of pocket.” However, for seniors who have cataract surgery that implants an intraocular lens, Medicare Part B will chip in for one pair of eyeglasses or one set of contact lenses.

Dental care. Medicare doesn’t cover routine dental care, including cleanings, fillings and tooth extractions. The health plan also won’t pay for dentures or dental plates. However, Medicare Part A might pay for certain dental services you get while hospitalized during an emergency.

Hearing aids and exams. Medicare Part B covers diagnostic hearing and balance exams that are ordered by a doctor to access function, but it won’t cover routine hearing exams. Hearing aids and the exams for selecting and fitting an appropriate hearing aid are also not covered by Medicare.

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