Planning Your Medicare Coverage Gaps

Medicare generally does not pay for glasses, hearing aids, or dental work for many Medicare beneficiaries. If your health deteriorates and you require extensive long-term care, Medicare will cover only a limited amount of time under specific conditions. Listed below are some medical services Medicare doesn’t cover.

Dental care

Preventive care or treatment for dental issues won’t be covered. Medicare does not cover routine dental cleanings and fillings. Additionally, dental devices such as dentures and bridges aren’t covered. You might be eligible for coverage under Medicare Part A for certain dental services if you are hospitalized in an emergency.

Hearing aids

Hearing becomes more difficult for retirees as they age. Hearing aids and the exam needed to select and fit an appropriate device won’t be covered by Medicare. If your doctor deems a hearing and balance exam necessary, Medicare may cover it, but a copayment, coinsurance, and deductible may apply. Sound-producing devices that are surgically implanted, such as cochlear implants, may be covered by Medicare.

Routine eye examinations

Medicare does not cover vision checks to prescribe glasses or contact lenses. People with specific conditions may be covered by Medicare Part B for eye exams and tests, such as an annual glaucoma test, a yearly diabetic retinopathy eye exam, and tests and treatments for age-related macular degeneration. During your first year of Medicare Part B, a simple vision test may be provided during your “Welcome to Medicare” preventive care visit.

Glasses and contacts

Contact lenses and glasses are usually not covered by Medicare for older people. If you undergo cataract surgery that implants an intraocular lens, Medicare covers one pair of eyeglasses or one set of contact lenses. Additionally, Medicare pays for cataract surgery using traditional surgical methods or lasers.

Cosmetic surgery

In most cases, Medicare won’t cover cosmetic surgery. Medicare might cover the surgery if necessary due to an injury or deformity. For example, artificial limbs and their replacement parts, as well as artificial eyes, are covered by Medicare. A breast prosthesis is available to breast cancer survivors following a mastectomy.

Routine foot care

Medically necessary podiatrist services, such as hammer toes, bunions, and heel spurs, will be covered by Medicare Part B. Medicare does not cover routine foot care, such as corn removal, nail maintenance, or foot cleaning. Diabetes patients and other specific conditions may be covered for foot exams and treatments.


Acupuncture treatments, however, are not covered by Medicare, and Medicare may cover chiropractors for manipulating the spine, but not for massage therapy or X-rays.

Care received outside the U.S.

Health care received abroad is typically not covered by Medicare. In rare circumstances, Medicare will pay, such as if a foreign hospital is closer than a U.S. hospital to treat a beneficiary injured in the U.S. You may also be covered if you receive emergency medical care in Canada while traveling between Alaska and the continental U.S. You may receive Medicare coverage while aboard a ship in U.S. territorial waters.

Personal care

A personal care service is usually not covered by Medicare if you need help bathing, dressing, or getting up. Generally, Medicare doesn’t cover housekeeping services, such as grocery shopping, home delivery of meals, or 24-hour care. If you qualify for Medicaid or have insurance that covers long-term care, you may be able to receive assistance with the cost of custodial care.

Long-term care

Following a hospital stay of three or more days, Medicare will pay for a short-term stay in a nursing facility. An inpatient stay might include a semi-private room, meals, and skilled nursing and rehabilitative services, such as intravenous injections and physical therapy. Cost-sharing isn’t required for the first 20 days, but for days 21 through 100, you’ll have to pay $170.50. Nursing home stays longer than 100 days will not be covered by Medicare.