Millions of seniors get health benefits through Medicare, but many are surprised to learn that the program is somewhat limited in what it actually covers. If you’re a new subscriber, or are gearing up to enroll, here are 4 services not included in your Medicare coverage:
Routine Dental Care
Know those dental cleanings and checkups you’re supposed to get twice a year? Unfortunately, you’re on your own in regards to footing the bill. Medicare will only cover dental care as it relates to an injury, or if it’s needed in conjunction with a covered medical service. Routine care, which includes cavity fillings and even dentures, is not covered.
Getting your eyes checked annually is important, since the wrong prescription can result in headaches and other health issues. Medicare, however, won’t cover routine eye exams, nor will it cover the cost of eyeglasses. That said, it will cover screenings and treatment for certain eye diseases. For example, high-risk patients can get a glaucoma screening annually, while diabetics can receive screenings and treatment for retinopathy. Medicare will also pay for cataract surgery and procedures to treat other vision-damaging conditions like detached retinas.
Hearing loss is common among seniors, but it is not something Medicare will pay to treat. If you require hearing aids, you’re on your own to cover their cost.
Many seniors wind up needing long-term care, whether in the form of a home health aide, nursing home, or assisted living facility. Medicare, however, won’t pay for what’s known as custodial care, which is assistance with daily living tasks. As such, long-term care usually isn’t covered.
Read more about long-term care coverage at Medicare Resources.
How to Get Coverage for the Services You Need
Although the above services aren’t picked up by Medicare, if you opt for Medicare Advantage instead, your plan will generally cover the first three. Medicare Advantage is an alternative to original Medicare, and it commonly covers dental care, vision services, and hearing aids — and sometimes at a lower cost, premium-wise, than what you’ll pay for original Medicare, which charges enrollees a premium for Parts B and D.
As far as long-term care goes, coverage varies depending on the Advantage plan you get. Some plans will pick up the tab for home- and community-based services like assistance with daily living and meal delivery for those who are homebound. It certainly pays to look into long-term care insurance, which can help defray the otherwise astronomical cost of nursing home and assisted living care. The best time to apply for a long-term care policy is in your 50s, when you’re most likely to not only qualify, but snag a health-based discount on your premiums.
Know Your Costs Under Medicare
Many seniors are caught off-guard when they realize Medicare won’t cover the above services. Supplemental insurance is by no means a solution either, since Medigap won’t pay for services not included in Medicare’s scope of coverage. Know what to expect from Medicare so you can budget accordingly for the care you need.