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What is not covered by Medicare?

Question 3 of 4 (use "Last" or "Next" buttons to see more)
Last Update: July 29, 2010

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;

      To learn more about Medicare's new prescription drug benefit, click on the link in the GO TO box.

  • some preventive care, including most routine physical examinations and tests, immunizations, and routine foot care and eye care;

      To learn more about what preventive services Medicare does cover, click on the link in the GO TO box.

  • transportation, except for medically necessary ambulance services; and
  • 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 pay 100 percent of the cost. Unless you have supplemental insurance, you will have to pay premiums, deductibles and coinsurance.

    To learn more about your out-of-pocket costs, click on the links in the GO TO box.

    To learn more about supplemental insurance that helps pay for costs that Medicare does not cover, click on the link in the GO TO box.


Case Examples
Mr. C’s HMO considered his treatment to be experimental and did not want to cover it, but Mr. C was able to show it was medically necessary and get coverage

Related Questions
Does Medicare cover ambulance transport to a doctor's office?

When does Medicare cover eye care?

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GO TO
Does Medicare ever cover dental services?

Does Medicare pay for ambulance services?

If Medicare will not pay for my dental care, what other resources could help me pay?

When does Medicare cover eye care?

How do I enroll in the Medicare prescription drug benefit (Part D)?

What preventive care services does Medicare cover?

What do I have to pay for services covered under Medicare Part A?

How can I get help with my Medicare costs and fill in the gaps in Medicare coverage?

 
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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