What Medicare Does Not Cover and Why It Matters

Do You Need Additional Coverage?

Medicare is the predominant health care for millions of American seniors. It is ironic that health insurance intended to care for the elderly does not cover many of the most common medical needs in this age group. Find out what Medicare does and does not cover. Only then can you decide if you need to seek out additional health coverage.

Dental Care and Dentures

Dentures Medicare
Medicare does not cover dentures. bobbieo/E+/Getty Images

Medicare does not cover routine dental cleanings, screenings or dentures. Near 23 million seniors have no teeth at all while 12 million have no teeth in one arch. A complete pair of dentures could cost into the thousands of dollars. The only time Original Medicare will cover dental care is if a dental extraction is required as part of another Medicare-approved procedure, if a dental extraction is needed to prepare your mouth for cancer treatments to the mouth or jaw, if a pre-operative examination is indicated before kidney transplant or heart valve replacement or if a dental procedure requires inpatient hospitalization for completion.


American College of Prosthodontists. Facts and Figures. http://www.gotoapro.org/news/facts--figures/. Accessed July 20, 2015.

Hearing Tests and Hearing Aids

Hearing Aids Medicare
Medicare does not cover hearing aids. Thinkstock/Stockbyte/Getty Images

After 65 years of age, more than 30 percent of people have some degree of hearing loss. That number increases to more than half at 75 years of age. Medicare does not cover the cost of routine hearing screening though it will cover for audiology testing if you show signs of hearing loss. The benefits stop there. Even if you are found to have hearing loss, hearing aids will not be covered by Original Medicare. Depending on the quality of the hearing aid, this could cost hundreds to thousands of dollars for a pair.


Hearing Loss Association of America. Basic Facts About Hearing Loss. http://www.hearingloss.org/content/basic-facts-about-hearing-loss. Accessed July 20, 2015.

Vision Screening and Corrective Lenses

Glasses Contact Lens Medicare
Medicare does not cover corrective lenses. Westend61/Westend61/Getty Images

Medicare does not cover routine vision screening or the cost of corrective lenses, i.e. eyeglasses or contacts. In 2012, 20.6 million Americans experienced vision loss with 5.3 million adults over 65 years of age reporting significant impairments. Annual vision exams will be covered by Original Medicare for those with diabetes, glaucoma, and age-related macular degeneration but again, no corrective lenses. Glaucoma screening may be considered but only for those considered to be high risk.


American Federation for the Blind. Facts and Figures on Adults with Vision Loss. http://www.afb.org/info/blindness-statistics/adults/facts-and-figures/235. Updated May 2014. Accessed July 20, 2015.

Certain Services for the Blind

White Canes Blind Medicare
Medicare does not cover white canes for the blind. Huntstock/DisabilityImages/Getty Images

Being blind goes beyond vision impairment and the need for corrective lenses. The condition requires that measures be in place to assure safety and function. Despite this, Medicare does not cover white canes that are used by the blind to help them navigate around their surroundings. Medicare also declines coverage for service dogs to assist the blind in their day to day living.

Long-Term Nursing Home Care

Nursing Home Medicare
Medicare does not pay for long-term care in nursing homes. Vstock LLC/Tetra images/Getty Images

Dementia increases as we get older. More than 40 million Americans have dementia and the number is expected to increase. This can make it challenging for seniors to live safely on their own. At a time when the need for long-term nursing home care is greatest, Medicare will not cover the service. Coverage in a skilled nursing facility will only be covered after a qualifying inpatient hospital stay and then only for a limited period of time.


National Institute of Neurological Disorders and Stroke. Dementia: Hope Through Research. http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm​. Accessed July 20, 2015.

Health Care When You Travel Out of the Country

Emergency Care Medicare
Medicare does not cover health care when you travel out of the country. Westend61/Brand X Pictures/Getty Images

Medicare may not offer coverage during foreign travel. Take care to plan your trips carefully. Coverage may be granted in these limited scenarios:

  • There is a medical emergency and even though you are in the United States, the closest hospital is in a foreign country.
  • You can use a foreign hospital for care if that hospital is closer to your home than an American hospital.
  • You may receive care in Canada when traveling directly between Alaska and the contiguous United States.
  • Medicare will only cover care on a cruise ship if you are within six hours of a U.S. port or U.S. territory waters.

Basic Life Essentials

Custodial Care Hygiene Basic Needs
Medicare does not cover custodial care. Mark Gabrenya/E+/Getty Images

Some things are essential for quality of life and many of these direct impact on your health, safety and wellness. Medicare does not cover custodial services that include hygiene, dressing and feeding since they are not considered to require skilled care. It also does not cover housekeeping services or meals. 

What Are Your Options?

If you need additional health coverage, you have a number of options available to you. You could defer Original Medicare (Parts A and B) for a Medicare Advantage (Part C) plan that offers you more of the services you need. These plans are offered through private insurance companies. Alternatively, you could add a supplemental insurance plan, also through a private insurance company, to your Original Medicare benefits. Depending on your eligibility, Medicaid could also offer assistance.

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