What Medicare Doesn’t Cover

MedicareIt is very important to understand what Medicare does and does not cover when you are thinking about your future, and the possible need for long term care. To ensure that you get the type of care you desire, which for most people is home care, it is necessary to make sure you have the appropriate funds in place. The following article will articulate those specific things that are NOT generally covered by Medicare so that you can plan appropriately. At Advocare, we provide home care management to area seniors throughout South Florida. 

While Medicare covers a wide array of health care services, it certainly doesn’t cover everything. If you need or want certain services that aren’t covered, you’ll have to pay for them yourself unless you have other insurance or you’re in a Medicare Advantage health plan, which may cover some of these services. Here’s a rundown of what original Medicare generally does not cover.

Alternative medicine: This includes acupuncture or chiropractic services (except to fix subluxation of the spine), and other types of alternative or complementary care.

Cosmetic surgery: Elective cosmetic procedures are not covered, however, certain surgeries may be if necessary to fix a malformation. For example, breast prostheses are covered if you had a mastectomy due to breast cancer.

Long-term care: This includes nursing home care, the costs of assisted living facilities and adult day care. Medicare does, however, help pay up to 100 days of skilled nursing or rehabilitation care immediately following a three-day inpatient hospital stay.

Personal care: The cost of hiring help for bathing, toileting and dressing are not covered unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning, are not covered either unless you are receiving hospice care.

Routine dental and vision care: Medicare will not cover routine dental checkups, cleanings, fillings or dentures. Nor do they cover routine vision care like eye exams, eye refractions, contact lenses or eyeglasses — except when following cataract surgery.

Hearing: Routine hearing exams and hearing aids are not covered either, although some hearing implants to treat a severe hearing loss may be covered.

Foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns and calluses, nor does it pay for most orthopedic shoes or other foot supports (orthotics). Medicare will, however, cover foot injuries or diseases like hammertoes, bunion deformities and heel spurs, along with foot exams and treatments if you have diabetes-related nerve damage.

Non-emergency services: Medicare does not pay for copies of X-rays or most non-emergency transportation including ambulette services.

Overseas coverage: In most cases, health care you receive outside of the United States is not covered.

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