7 Shocking Things Medicare Doesn’t Cover and How to Prepare!

1. Long-Term Care

Many people believe Medicare will cover long-term care, but this is a big misconception. Medicare only covers up to 100 days in a Skilled Nursing Facility following a hospital stay. After that, you’re responsible for all costs, which can easily exceed $10,000 per month.

How to Prepare:

• Long-term care insurance: You can invest in a hybrid or traditional long-term care policy.
• Self-funding: Some people choose to save money to cover potential long-term care costs.
• Medicaid: If you meet certain income and asset limits, Medicaid may help cover long-term care expenses.

2. Dental, Vision, and Hearing Care

Medicare does not cover routine dental checkups, cleanings, vision exams, eyeglasses, or hearing aids unless they are related to a medical condition like glaucoma or cataracts. This means you are on your own when it comes to these essential services.

How to Prepare:

• Standalone dental, vision, and hearing policies are available to help with costs.
• Medicare Advantage plans often include limited dental, vision, and hearing coverage.
• Pay out-of-pocket if insurance isn’t an option.

3. Prescription Drugs Purchased at a Pharmacy

While Medicare Part B covers certain medications administered in a hospital or outpatient setting, it does not cover prescription drugs purchased at a pharmacy. This is why Part D prescription drug coverage is essential for most beneficiaries.

How to Prepare:

• Enroll in a Part D plan to ensure coverage for prescription drugs.
• Choose a Medicare Advantage plan that includes drug coverage.
• Compare drug formularies to find the best plan for your medications.

4. Foreign Travel Coverage

Planning to travel abroad? Original Medicare does not cover medical emergencies outside the U.S. This means if you get sick or injured in another country, you could face massive medical bills.

How to Prepare:

• Medicare Supplement Plans G and N offer limited foreign travel coverage, but only up to $50,000 for the lifetime of the policy.
• Travel insurance policies provide broader coverage for medical emergencies, trip cancellations, and lost luggage.

5. Acupuncture and Chiropractic Services

Medicare only covers limited chiropractic care if it is deemed medically necessary, such as spinal subluxation. However, routine chiropractic adjustments and acupuncture are not covered.

How to Prepare:

• Some Medicare Advantage plans include acupuncture and chiropractic coverage.
• Pay out-of-pocket for these services if needed.

6. Home Care Services

While Medicare covers some short-term home health services following hospitalization, it does not cover long-term custodial care such as help with bathing, dressing, cooking, or cleaning. This can leave many seniors struggling to get the care they need at home.

How to Prepare:

• Home recovery care policies can help cover in-home assistance.
• Long-term care insurance may also include at-home care benefits.
• Personal savings or Medicaid may be needed to cover additional home care expenses.

7. Routine Foot Care

Medicare does not cover routine foot care, such as nail trimming or callus removal, unless it is medically necessary due to conditions like diabetes.

How to Prepare:

• Look for Medicare Advantage plans that include podiatry benefits.
• Consider paying out-of-pocket for routine foot care services.

Final Thoughts: Protect Yourself from Coverage Gaps

Now that you know what Medicare doesn’t cover, it’s time to take action. Review your coverage options carefully and explore additional policies that can help fill in the gaps. Whether it’s a Medicare Supplement plan, Medicare Advantage, or standalone insurance, being proactive will save you thousands of dollars in unexpected costs.

Need Help Navigating Medicare?

If you have questions about Medicare coverage or need help finding the right plan, give us a call at 800-208-4974 or book an appointment. We’d be happy to assist you!