Medicare Benefits: The 8 Things Medicare WON’T Cover

When you turn 65, you will be eligible for Medicare benefits. This insurance can help you with a variety of medical needs when you lose your company-provided insurance after retirement. It can pay for expenses that you might not be able to cover with the limited income you receive monthly; however, there are some important things Medicare won’t cover that you should know about.

8 Things Medicare Benefits Won’t Cover

Medicare will cover a lot of things that may arise as you age, but knowing what it won’t cover can help you make better decisions about future expenses or whether you need supplemental insurance to cover extra costs. Here are a few things that Medicare won’t cover:

Dental Care and Devices

Going to the dentist on a regular basis keeps your teeth clean and healthy. As you age, it’s important to keep up with this practice. The health of your teeth and gums has an impact on your overall health. However, if you only have Medicare benefits, preventative care and treatment for visits to the dentist won’t be covered.

In addition, if you need dentures or other dental devices, these won’t be covered either. You will need to have supplemental insurance to take care of these costs. Otherwise, you will be responsible to pay for them on your own.

Hearing Aids

As you age, you might experience hearing loss. This is an incredibly common ailment that impacts many older individuals. Thankfully, technology has advanced and developed devices that can help you hear and communicate with loved ones. However, if you find that you need hearing aids later in life and only have Medicare benefits, the cost of these devices won’t be covered. The cost of the hearing exam won’t be covered either.

It may be possible to get hearing issues covered if your doctor orders a hearing and balance exam, deeming this procedure necessary. But there are no guarantees, and a deductible, copayment, and coinsurance may be required. If you have to get a surgically implanted hearing device, Medicare might cover this. Again, there are no guarantees.

Eye Exams

Aging also brings about issues with your eyes, which is why it’s so important to have routine eye exams. These will catch any problems that might arise before they become huge issues. However, don’t expect Medicare benefits to pay for this check-up.

If you have Medicare Part B and certain medical conditions, this plan may cover annual exams for glaucoma, diabetic retinopathy, and tests and treatments for age-related macular degeneration. You may also be provided with an eye exam during the first year you have Medicare Part B.

Since Medicare isn’t covering your eye exams, don’t expect it to cover the cost of your glasses and contacts, either. The only time there is an exception to this is when you have to get cataract surgery and an implanted intraocular lens. Then it will cover the cost of one pair of eyeglasses or one set of contacts.

In addition, Medicare will also cover the cost of cataract surgery that is done with traditional methods or lasers. However, if you need any other operation or procedure done to your eyes, these expenses won’t be covered by your Medicare benefits.

Long-Term Medical Care

Advances in medical care have made it possible for people to live longer lives, but they may not be able to take care of themselves properly. When that happens, they may have to go to a senior living facility, including nursing homes or memory care facilities. Unfortunately, Medicare doesn’t pay for these expenses except under very specific circumstances.

The only time Medicare benefits will pay for a stay at a nursing facility is if you were previously at the hospital for more than 3 days. If your stay is required to help with your care, they will pay the expenses for up to 20 days. This could include having a semi-private room as well as your meals and rehabilitative services.

If you have to spend 21 days or more at the nursing facility, you will start to acquire costs that will need to be covered by supplemental insurance or out of your pocket. For any stays that are more than 100 days, Medicare won’t pay at all.

Personal Care

If you don’t need to go to a nursing facility, but you need some assistance while you stay at our own home, such as from a home health nurse, Medicare benefits won’t cover these costs. This includes services such as help with life tasks like bathing and dressing, cooking meals, or housekeeping and running errands.

Even if it’s medically necessary to have a qualified person come to your home, it still won’t be covered. You’ll have to have supplemental insurance or Medicaid to cover these custodial costs.

Medical Care When Traveling

If you are in good health and want to travel, then get out and see the world. While there, however, keep in mind that if a medical emergency should arise, your Medicare benefits won’t cover the cost. Even if you get a common illness and have to go to the doctor, this still won’t be covered by Medicare.

That shouldn’t stop you from traveling, though. Knowing that these expenses won’t be covered can help you plan ahead and have an emergency fund available or get special travel insurance. Or you might decide to find a general supplemental insurance plan that will take care of these expenses should they arise.

Acupuncture and Chiropractic Treatments

Many people have a desire for alternative medical treatments. While modern medicine has made a lot of breakthroughs and can cure and treat a variety of ailments, it can also be incredibly intrusive or have unwanted side effects. If you decide to go with ancient practices, such as having acupuncture, you’ll be paying the bill on your own.

If you need to go to the chiropractor for an adjustment or other issues, Medicare benefits will cover the cost if it is deemed medically necessary. However, it may not cover the cost of other services such as X-rays or massage therapy.

Cosmetic Surgery

Should you decide you want to fight the aging process and get a facelift, tummy tuck, or other cosmetic surgery procedure, Medicare benefits definitely won’t cover any of these. In fact, most insurance plans won’t cover these procedures. Unless they are deemed medically necessary, you will be paying for these expenses on your own.

Some of the things that Medicare might cover when it comes to cosmetic items include things such as artificial limbs and eyes. If you are a breast cancer survivor that has had a mastectomy, then you are eligible for breast prosthesis through your Medicare benefits.

Finding Ways to Cover These Expenses

Medicare benefits cover many medical issues that might arise; but it won’t cover them all. When you have medical issues that you can’t manage through Medicare, you need to find ways to cover these expenses. There are several ways to do this, including getting supplemental or secondary insurance.

There are also Medicare supplement plans that you can add to your primary care plan. They will have costs associated with them—as all insurance plans do—but the monthly premium could save you having to pay huge costs for an uncovered condition. The key is finding the right plan for you.

A Plan that Works for You

When it comes to supplemental or secondary insurance, you want to go with a plan that will fit your needs and budget. It’s hard to predict what the future will hold, but if you have the right insurance plan, it will cover any issue that might arise. You may be healthy now, but that could change in an instant.

You’ll also need to find a plan that will fit into your budget. Remember, you probably won’t have the same income you had when you were working. Supplemental insurance will cost, but there are many different plans to choose from, so it should be possible to find one that will fit your needs and budget.

Talking to an insurance provider before your 65th birthday is advised. Once that time rolls around, Medicare becomes your primary insurance. While you can put other plans in place later, it’s a good idea to have everything ready to go to avoid penalties or the possibility you will be denied coverage. Once that happens, you will have a hard time finding supplemental insurance to cover your expenses.

Working With an Insurance Agent

Working with an insurance agent who understands Medicare benefits and the supplemental insurance option will be advantageous in finding you the right plan. They will be able to look at your current situation and lifestyle and find a plan that will be cost-effective yet comprehensive.

If you don’t plan on traveling in your retirement years, you won’t need a plan that covers medical expenses outside of the U.S. However, you will probably need dental care and vision exams. If you visit the chiropractor for ailments, then you’ll want something to cover those expenses.

No matter what your situation is, there is an insurance supplement that can help cover the cost. Talk to the professionals at Senior Solutions Group today to find the Medicare benefits and supplemental insurance that will keep you covered as you grow older.

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