What is not covered by Medicare?

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Medicare does not cover all health care services. Health care services not covered by Medicare include, but are not limited to:

  • alternative medicine, including experimental procedures and treatments, acupuncture, and chiropractic services (except when manipulation of the spine is medically necessary to fix a subluxation of the spine. A subluxation is when one or more of the bones of the spine move out of position);
  • most care received outside of the United States;
  • cosmetic surgery (unless it is needed to improve the function of a malformed part of the body);
  • most dental care;
  • hearing aids or the examinations for prescribing or fitting hearing aids (except for implants to treat severe hearing loss in some cases);
  • personal care or custodial care, such as help with bathing, toileting and dressing (unless homebound and receiving skilled care) and nursing home care (except in a skilled nursing facility if eligible);
  • housekeeping services to help you stay in your home, such as shopping, meal preparation, and cleaning (unless you are receiving hospice care)
  • non-medical services, including hospital television and telephone, a private hospital room, canceled or missed appointments, and copies of x-rays;
  • most non-emergency transportation, including ambulette services;
  • some preventive care, including routine foot care  
  • most vision (eye) care, including eyeglasses (except when following cataract surgery) and examinations for prescribing or fitting eyeglasses.

Keep in mind that even for Medicare-covered services, Medicare does not usually pay 100 percent of the cost. Unless you have supplemental insurance, you will usually have to pay deductibles and coinsurances. Most preventive services are covered by Original Medicare with no copays or deductibles.

If you are in a Medicare Advantage plan (sometimes called a Medicare private health plan), your plan may cover some of these services. Check with your plan to find out what additional benefits they offer.

 


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LINKS
Centers for Medicare and Medicaid Services (CMS)

Medicare.gov Medigap (Medicare Supplement) Policies & Guide

Medicare.gov -- Original Medicare Coverage Information Finder

National Directory of Medicare Regional Carriers and Intermediaries

Medicare.gov: National A/B MAC Information

 
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