Key Services Medicare Doesn’t Cover

Caregiver Corner, Healthy Aging, Senior Care Leave a comment , , , , ,

Every day, 10,000 Americans turn 65 and begin Medicare coverage. At last, they have health care coverage for life! But what many don’t realize is the array of services they’ll still have to pay for on their own.

Despite all the things Medicare covers, it is not a head-to-toe plan. The average couple who retires at age 65 will wind up spending another $280,000 on health care throughout the rest of their lives. Here are some of the gaps you’ll need to watch out for:


Medicare will cover glaucoma, cataracts and macular degeneration. But for the routine vision checks most of us require, you’ll be paying out of your own pocket. Ditto for eyeglasses and contacts.

For help with the cost of eye examinations, check around for the best deal. Costco and Sam’s Club offer inexpensive exams that may justify the price of a membership.


Half of seniors above age 75 have disabling hearing loss, but you’ll have to pay out of pocket for hearing aids since Medicare doesn’t cover them. And hearing loss is not something you want to let go, because your brain loses its ability to interpret the signals sent by your ears as you lose your hearing.

The FDA is in the process of evaluating and rating personal sound devices, which sell for much less.  Check out a previous article we shared on this topic in August:


The average cost per senior for annual dental care is a whopping $685, and specialty visits will tack on more. Medicare doesn’t cover preventive cleanings and x-rays, nor fillings or root canals. If you need dentures, you’ll have to cover them, and ditto for oral surgery to combat gum disease.

If you have a Medicare Advantage plan, you may have some coverage for routine visits to an in-network dentist. Contact your insurer to find out if you have a dental plan.

It’s worth asking if your dentist will give you a cash discount or provide a payment plan. The latest research shows you really only have to visit once a year to get the same benefits provided by recommended twice-yearly cleanings.

Long-term care

Custodial care (also known as “Assisted Living”), the routine care that usually pushes many older adults into nursing homes, is not covered under Medicare.   Home care (for companionship, light housekeeping and cleaning, etc.) for seniors who are aging in place is also not a covered benefit.

Not everyone is going to need long-term care, but what if you do? You can buy a long-term care insurance policy that will help cover costs.  Contact your Choice Connections Advisor to help you determine if there are others benefits which may help you pay for long term care.


Rehabilitation involves skilled nursing care, which is covered under Part A if you’ve been admitted to the hospital for at least three days. But if they only admitted you for observation, you’re out of luck and rehab will come out of your wallet.

Always ask the hospital to admit you. In some cases, they may refuse. Be aware that going to the hospital and even spending the night does not always mean you’ve been officially admitted.

In summary

The most important thing you can do before you schedule a procedure is check with Medicare, or your Medicare Advantage insurer, to see if a procedure is covered. Secondly, check around for deals before you buy services or aids. Finally, make sure the hospital (which should be in-network if that’s a requirement) is coding you as “admitted” and not “observation.”

It’s a good idea to have a friend or family member aware of your needs so you have an advocate to accompany you.

Source:  CSA Blog, September 17, 2018

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