What Medicare Doesn’t Cover

What Medicare Doesn’t Cover

Medicare is a federally funded program that offers health care insurance for people aged 65 years and above as well as those getting Social Security Disability Insurance (SSDI). The program is run by the Centers for Medicare and Medicaid Services (CMS). Medicare is partially funded by social security and Medicare taxes. Once a person has qualified to enroll in the Medicare program, they can decide to get their benefits from the original Medicare. However, it’s always best to know upfront what Medicare will not cover:

1. Opticians and eye exams

The Medicare program doesn’t have opticians and eye exams for eyeglasses or contacts themselves. But Medicare Part B covers one pair of glasses or contacts in case a patient has cataract eye surgery. You may also get coverage if you purchase a Medicare Advantage plan with vision benefits. It is important to find out everything that’s covered by the program during the enrolment period.

2 .Hearing aids

Medicare also does not cover hearing aids or the exams needed for hearing aids. Although there’s a provision in the Build Back Better Act to include hearing aid coverage to Medicare, the act has not yet been implemented by congress. Medicare doesn’t pay for diagnostic hearing exams irrespective of whether your doctor thinks you need them or not.

3. Dental work

Even though Medicare Part A covers certain dental services, other common dental care services such as X-rays, cleanings and fillings are not covered. Those who want coverage must buy a separate dental policy. You can easily get coverage if you buy a Medicare Advantage plan that has dental benefits. However, the benefits are limited to a certain amount of money. You can pay extra money to enjoy more benefits.

4. Chiropractic

Medicare covers chiropractic manipulation of your spine to help in the management of back pain. But this is on condition that the patient has active back pain. The plan only covers chiropractic care that is meant to rectify an existing problem. It does not cover spinal manipulations as preventive or maintenance services. Medicare also doesn’t cover X-rays or massage therapy. You should find out the cost of each service in case your doctor offer or recommends them to you or your loved one.

5. Overseas care

The Medicare program won’t cover a person if they are outside the boundaries of the United States and some U.S. territories. This is something to note if you are planning to relocate to another country. In case you return and want to re-enroll back to the program, you may be subjected to Part B penalties.

6. Nursing home care

Medicare covers nursing care in certain instances. For example when your doctor has established that you need daily and skilled nursing care to treat a hospital-related condition. However, Medicare doesn’t cover nursing home care in case the only care required is custodial. Additionally, the Medicare Plan A benefits won’t cover nursing home care for more than 100 days.

7. Podiatry

Medicare only covers podiatry in specific situations. Medicare Part B covers annual exams and treatment for feet for individuals with diabetes-related nerve damage. But in most cases, Medicare won’t cover routine foot care cases. For instance, nail trimming, general cleaning, or removing corns are not covered by Medicare.

In general, Medicare health insurance covers a wide range of health conditions. It is a program designed to help reduce the cost of medical care for a certain group of people. However, there are certain conditions or instances where you can’t use Medicare.