10 services Medicare does not cover

There are various services that Original Medicare (parts A and B) does not cover, including vision, dental, and hearing. However, Medicare Advantage (Part C) offers coverage for many of these.

However, Original Medicare does not cover everything. For example, it does not cover dental, vision, and hearing care.

These coverage gaps may be covered by Medicare Advantage (Part C), Medicaid, or a Program of All-Inclusive Care for the Elderly (PACE) plan.

With Original Medicare, a person is responsible for 100% of the cost for these vision services.

After a Medicare-approved cataract surgery with intraocular lenses, Part B will cover one pair of prescription glasses with standard frames or one set of contact lenses.

Part B will also generally cover an annual eye exam for diabetic retinopathy or glaucoma for people who are at high risk. It also covers eye exams and treatment for macular degeneration.

After a person meets their Part B deductible, currently $257, they are responsible for 20% of the Medicare-approved costs.

Original Medicare does not cover hearing aids or the exams to fit them. A person is responsible for 100% of the cost associated with hearing aids.

Medicare Part B covers hearing and balance exams if a healthcare professional deems them medically necessary for diagnosis and treatment.

Medicare may cover a yearly visit to an audiologist without a referral from a healthcare professional if a person:

After an individual has met their Part B deductible, they are responsible for 20% of the Medicare-approved costs for hearing services. If they receive these services as an outpatient at a hospital, the person may also have to pay the hospital copayment.

The individual is responsible for 100% of the cost for these services.

Medicare Advantage plans may offer dental coverage as an additional benefit.

Original Medicare only covers exams or treatment from a podiatrist if a person has diabetes-related nerve damage in their lower leg that may increase the risk of limb loss or if they require medical treatment for foot injuries or deformities, such as:

Once a person reaches their Part B deductible, they are responsible for 20% of the costs for Medicare-approved services and treatments.

Medicare does not cover routine physical exams. This is defined as an exam that is performed with no relation to treatment or diagnosis of a specific symptom, condition, or illness.

The individual is responsible for 100% of the cost associated with this type of exam.

Medicare offers yearly wellness visits, also called annual wellness visits (AWVs). These visits are not physical exams. They are appointments offered every 12 months that are designed to create or update a personalized prevention plan and perform a health risk assessment.

The individual pays nothing for these annual wellness exams.

Original Medicare does not cover cosmetic surgery unless it is needed to improve the function of a malformed body part or due to accidental injury.

The individual is responsible for 100% of the cost of noncovered cosmetic surgery.

Certain procedures may or may not be considered cosmetic and require prior authorization for Medicare to cover them. These procedures include:

Medicare will cover breast reconstruction surgery if a person has had a mastectomy due to breast cancer.

Medicare covers spinal manipulation from a chiropractor for people with vertebral subluxation. Vertebral subluxation occurs when the joints of the spine do not move properly, but the contact between the joints is still intact.

However, Medicare does not cover other services or tests that are ordered by a chiropractor, such as X-rays.

Medicare does not cover massage therapy, even if a healthcare professional recommends the therapy. The individual is responsible for 100% of the associated costs.

Medicare only covers acupuncture for chronic lower back pain. It will cover up to 12 treatments within 90 days.

After the Part B deductible is met, the individual is responsible for 20% of the Medicare-approved costs.

Medicare does not cover long-term, or custodial, care, including medical or nonmedical care for individuals with chronic illness or disability.

Individuals may qualify for long-term care coverage through Medicaid or PACE. They can also look into purchasing long-term care insurance.

Original Medicare does not typically provide coverage for healthcare when a person is traveling outside of the United States.

For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.

There are certain services that Medicare does not cover. These include vision, dental, and hearing care.

A person may be able to get coverage for some of the noncovered services through Medicare Advantage, Medicaid, and PACE plans.