While Medicare provides coverage for numerous health-related expenses, it does not encompass every cost, a fact that may come as a surprise to some retirees. Many individuals assume that Medicare functions as an all-inclusive policy, which is not the case.
In addition to less well-known expenses, several common health-related costs fall outside Medicare’s coverage. This reality underscores the necessity for retirees to manage their spending and safeguard their savings. Although Medicare Advantage plans offer supplemental coverage, it remains crucial to thoroughly examine each policy for recurring expenses that may not be included.
Here are five frequently encountered expenses that Original Medicare does not cover:
1. Dental Care
Routine dental services such as cleanings, fillings, extractions, and dentures are typically excluded from Original Medicare plans. Coverage may only apply to dental services that are directly associated with an approved medical procedure or hospitalization, not for general dental care.
These smaller costs can accumulate, making it essential to factor them into retirement planning.
2. Vision Care and Eyeglasses
Original Medicare plans generally do not cover routine eye examinations, glasses, or contact lenses. However, exceptions exist for specific cases, such as eye exams for individuals with diabetes and glaucoma screenings for those at elevated risk.
Medicare Part B does provide coverage for eyeglasses with standard frames or a set of contact lenses after cataract surgery involving the implantation of an intraocular lens. According to the Medicare website, “after you meet the Part B deductible, you pay 20% of the Medicare-approved amount for corrective lenses” following each surgery.
3. Hearing Aids and Fitting Exams
As hearing loss becomes increasingly prevalent with age, it remains a cost that Medicare typically does not cover. Beneficiaries will need to pay for hearing aids and the necessary fitting exams; however, some Medicare Advantage plans may provide limited benefits related to hearing.
4. Long-Term Care
Long-term care represents the most significant financial burden on this list. According to a study by consulting firm Milliman, a 65-year-old today would need to set aside approximately $135,000 to cover average future lifetime costs of long-term care.
This critical expense is not addressed by Original Medicare, and Medigap policies usually do not provide coverage either. While certain situations may warrant short-term skilled nursing or rehab coverage, individuals may need to rely on personal savings if long-term care becomes necessary. Some opt for long-term care insurance to help mitigate these costs.
5. Healthcare Outside the U.S.
For those traveling abroad, separate travel health insurance may be essential to cover any potential medical expenses. Regularly, Medicare does not extend coverage for health-related conditions incurred outside the United States, although limited exceptions exist. For instance, Medicare Part B may “pay for inpatient hospital, doctor, and ambulance services you get in a foreign country in rare cases, if you’re eligible.” Additionally, Medigap policies sometimes offer restricted emergency coverage during foreign travel.
Before embarking on an international trip, it’s advisable to consider coverage options and plan for potential medical issues that might arise. Securing travel health insurance could be a prudent choice.