Things Senior Health Insurance Doesn’t Cover

Things Senior Health Insurance Doesn’t Cover
Medicare health insurance

Most seniors believe that their Medicare A or Part B plus coverage includes all Medicare-approved services and treatments. Unfortunately, some of the most costly medical needs are not covered. Read the following list of Medicare exclusions to ensure that you or a loved one does not have to pay out of pocket.


Hearing Aids

Most insurance policies do not cover hearing aids or audiologist services, which can cost thousands of dollars. Hearing loss affects one out of every three people over the age of 70, and nearly half of those over the age of 75 have difficulty hearing.


Dental Treatment

Unless you have an emergency or require a complicated procedure, dental care is not included. Dentures, which can cost between $1,000 and $5,000 for a full set, are not included. Tooth implants, which typically cost around $4,000 per tooth, are not included. Routine cleanings, X-rays, fillings, and dentures are also not covered by Medicare.


Also Read: Does Medicare Cover Dental Implants?


Eyeglasses and Other Vision Care

In most cases, vision care is not covered by insurance. Only the eye exam is covered by Medicare if you need glasses. Insurance does not cover both the testing for corrective lenses and the glasses themselves. The first pair of glasses after cataract surgery, on the other hand, is covered. Only basic lenses and a low-cost frame are covered in this case. Bifocals and transition lenses are not covered by Medicare.

Treatment for glaucoma, cataracts, and other eye diseases is covered, but medications are not unless you have a prescription drug plan. Contact lenses and LASIK surgery to correct vision are also not covered.


Also Read: Does Medicare Cover Cataract Surgery?


Incomplete Hospital Admissions

Admissions to hospitals must be properly coded. Medicare will not pay for your hospital stay if you are admitted to a hospital for observation. Make certain that you are admitted for treatment rather than observation. Stays in a rehabilitation hospital or center are not covered unless you have been a regular hospital inpatient for at least three days.


Senior Health Insurance


Health Care Outside of the United States

In general, health care received while traveling outside of the United States is not covered. Treatment is available in the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. In extremely rare circumstances, Medicare will pay for inpatient hospitalization, doctor visits, ambulance services, or dialysis in a foreign country.

Some low-income individuals may be eligible for programs that reduce their Medicare-related costs. Prescription drug coverage receives additional assistance, and some state-run savings programs can assist with copays, coinsurance, deductibles, and premiums. Those who do not qualify must pay out of pocket or purchase additional insurance. If you choose an Advantage Plan, you can expect dental and vision coverage to be included. It will, however, most likely be limited.


Also Read: Medicare Plan Terms Employers Need to Know


Unfortunately, except for some advantage plans, Medicare usually does not include a medical alert system, so you will have to take care of that on your own.

Medicare and other health insurance options for seniors can be complicated, so hopefully, we were able to answer some of your questions.


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