Health & Wellness / Your Medicare Advisor

Three Important Health Services Medicare Won’t Cover

medicare

Approximately 10,000 seniors turn 65 every day and become eligible for Medicare for their health-related needs. Although Medicare covers many necessary health-related services, the fact is there are three routine services that Medicare does not cover—services that often affect a senior’s overall health and quality of life.

Some health plans for those under 65 offer some of these routine benefits for an additional premium. However, once a person enrolls in Medicare, these much-needed routine benefits are paid for 100% out of the beneficiary’s pocket without any financial assistance.

Here are the three routine services Medicare does not cover:

1. Routine dental care

Proper oral health is critical for everyone, and even more so for seniors. Research has shown that poor dental health often results in other health issues. Unfortunately, Medicare won’t pay for routine care like dental cleanings, fillings, and dentures. It also won’t cover most oral or gum surgeries. The only exception is for patients who need these exams or surgeries in conjunction with another medical procedure or issue.

That said, seniors do have options for securing dental coverage. First, you can buy dental insurance on your own, though the price of a plan might be so high that you’d be better off just paying for your dental care out of your pocket.

2. Hearing aids

People generally suffer significant hearing loss as they get older. This loss of hearing ability also results in several other health-related issues due to the isolation the loss of hearing ability brings. Again, Medicare coverage comes up short in this regard, which is unfortunate, as there is a vast array of hearing-aid technologies currently available, from simple and relatively inexpensive analog circuits to complex and expensive digital devices that require sophisticated fitting procedures. The average price of a digital hearing aid is about $1500, with top-of-the-line devices costing $3000 to $5000, according to the National Institutes of Health.

3. Vision services

Routine eye exams are crucial, since untreated issues can result in permanent damage. Ailments such as glaucoma and macular degenerations, along with a host of other ailments that affect a person’s vision, are often only diagnosed during a routine exam. Additionally, a large percentage of Americans, including seniors, rely on eyeglasses or contacts to see and function. Again, Medicare doesn’t pay for either eyeglasses or vision exams, though it generally does pay for eye care treatment that is medical in nature, such as an eye injury sustained during a fall. Similarly, it does pay for certain tests or treatments related to eye disease. Also, Medicare will pay for annual eye exams for diabetic retinopathy for those who have been diagnosed with diabetes, and it covers annual glaucoma tests for those deemed to be at high risk for the disease.

For seniors, health care is often the single greatest monthly expense. Knowing what Medicare does and does not pay for will help you budget properly for that period of your life.

Options:

You can consider enrolling in one of the many Medicare Advantage plans (Medicare Part C) available. These private plans are designed to replace original Medicare (Parts A and B) but maintain all the benefits of Parts A and B and usually include prescription drug coverage (Part D). Because these Medicare Advantage plans are offered by private insurance companies, many of them offer basic hearing, vision, and dental coverage as a benefit of the plan or as an optional supplemental benefit for an additional premium, resulting in some peace of mind that a portion of the costs for hearing, vision, and dental healthcare services may be covered.

If you have any questions please call AMAC’s Medicare Department to speak to one of our Trusted, Licensed Insurance Agents

Call 1-800-334-9330 or Get Quote

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L. Mapleaf

And yet the bums on MedicAID get complete coverage including dermo for acne and orthodonture…why is that?

Carla Sims

Please stop misleading people about Medicare Advantage plans. They do not work like traditional medicare. They require preauthorization for many things. For example, if you break a hip and need inpatient rehab, you’re probably not going to get an approval. So sad that people arent getting services they need. I see it everyday, so please stop lying to our seniors!!!!

Ralph Ormsbee

We just need to Fix Social Security and Medicare. You should have a movement on it. The Fix is that all of Congress,House and Senate can only Retire on Social Security and any public Job they may have put their time into as well as all federal and local Government Personal.

Rene A. Gowin

Sad because those three things are what every senior needs, we no longer need birth control or Vigra we need teeth hearing laughter and seeing our grand children.

Alice

They also do not cover, as I found out recently, a visit to “Patient First”. Went there with an infection in a toe, stubbed it–it bled and formed a scab. they treated it by taking xrays, removing the scab and dabbing with medication, gave me a foot thingy with open toes, an antibiotic and said visit a podiatrist for follow up. So far, they have not covered the foot thingy ($120) and I have not received anything yet on the remainder of the visit but did find out I had a staph infection in my toe per the podiatrist. It will probably take 1/2 my S.S. to pay for the visit. NOT HAPPY AT WHAT IS HAPPENING TO MEDICARE AT ALL.

Lindsey

I have a Medicare supplement, which really only pays what Medicare doesn’t. It doesn’t “supplement” additional things like dental care, vision, or hearing, which I believe it should. While having the supplement has been very helpful to me over the past year or so, I also pay a price for that supplement. I believe a supplement should SUPPLEMENT, not just pick up what’s left over.

Vickie

True, Medicare does not cover ROUTINE eye exams. BUT, they do cover your eye exams if you have a medical diagnosis such as cataracts, glaucoma and macular degeneration. AND, everyone age 65 or older does have either cataracts or has had cataract surgery (Most people develop cataracts between the ages of 40 and 60). However, if you are diagnosed with cataracts but they are not ready for surgery and glasses will help you see more clearly, Medicare does not cover the refraction (where the exam for determining the glasses Rx is determined) so you would have to pay for that as well as the cost of glasses out of pocket. And, if you purchase a plan that covers routine eye exams and glasses and then something like glaucoma or macular degeneration is diagnosed, your routine plan does not cover medical problems and you would have to schedule another appointment for… Read more »

Bill

Is cataract surgery covered?

Suzette Becker

It’s a sin that they don’t provide thes in Medicare!!!!
Other countries do.

Peg T

I have never learned how 2 acquire an HSA. Some years one can have less expenses than others. Having an HSA would serve as a self insured back up plan. At 89, my major expenses are eyes, dental & hearing. I have paid out an avg. of $5000 per yr but very little was ever used for the 3 mentioned in this article.

Timothy C.

My Medicare Advantage covers all three!

Paul

ABOLISH medicare irs and every government program….i thought we were conservatives that want LESS government. Medicare taxes collected during your life time of work average $150K while medical expenses per medicare recipient is 350K -yes a 200K deficit per person

Mary Blaylock

I would like some information on supplemental plans. I am a diabetic and wonder if they help with the cost of Insulin, Novalog or Lantus. The cost is very high, inflated by the makers who seem to care not a bit for the welfare of the patients who have to try to afford these products.

Mary Blaylock

I was wondering how much a supplemental coverage plan would cost. I think it is a disgrace the Medicare doesn’t offer a plan that covers dental, hearing and eye care. I have issues in all three areas, especially hearing. I am a diabetic and could sure use some help in covering the cost of insulin. I use Novalog and Lantus and they are very expensive. I have been waiting for a return call all day and wondered if any one was going to call before the end of the day. I realize you are very busy, but I am important also. Sincerely, Mary Blaylock, 805 967-8186

Joan

With my dentist, there is only one (1) plan in which he participates, and it is not a part of any Medicare Advantage program. It is independent. So, the best thing to do, if you like your dentist, ask what plans the office accepts. Google those plans and find out how you can join. I have Delta Dental, which has stand alone plans, so don’t let AARP make you think you have to have their version of it. It has several plans, but my DDS only participates in one of them, so verify before signing on the dotted line. Because I want this dentist, and am willing to keep my policy, I like the flexibility the Supplemental policies offer, and am not paying for extra dental coverage in an Advantage plan, which I will never use.

w. knight

I will NOT provide my phone number for this information to make a purchase from you. If l cant not get the info get plan elsewhere and will consider cancelling my membershipw.knight

Barry

Except for plans listed by my area (Aspire and Medicare Advantage F) nothing else is available. Looking for a Dental or Vision savings plan. Aspire has one but looking for better coverage.

Lynda McNary

Does AMAC have an insurance that covers Chiropractic or acupuncture treatments?