What kinds of health-related services are not covered by Medicare?

  • February 28, 2018

Q: What kinds of health-related services are not covered by Medicare?

A: With rare exceptions, Medicare Part A and Part B will not cover the following:

  • Routine care for the feet (treatment of foot injuries or diseases is covered though). Things like cleaning and caring for nails, or the removal of corns and calluses, are not covered by Medicare.
  • Orthopedic shoes
  • Vaccinations other than flu, pneumonia, and hepatitis B (those three are covered under Medicare Part B — for Hepatitis B, it depends on the enrollee’s risk factors —but other vaccinations are covered by Medicare Part D prescription drug plans)
  • Routine care for the eyes and eyeglasses (except following cataract surgery conducted with intraocular lens, when a pair of frames for eyeglasses is covered by Medicare)
  • Outpatient prescription drugs (covered by Medicare Part D)
  • Cosmetic surgery
  • Acupuncture
  • Dental care and dentures
  • Custodial care (help with bathing and dressing, help using the toilet facilities) in a nursing home or at home (long-term care insurance is needed for this to be covered, although Medicaid will cover long-term care for people who have exhausted their assets; seniors in nursing homes are often dual eligible for both Medicare and Medicaid, with Medicare covering their medical care and Medicaid covering their out-of-pocket costs under Medicare, as well as the cost of their custodial care)
  • Any health care required while traveling in a foreign country (Medigap plans C, D, F, G, M, and N pay a portion of these expenses)
  • Hearing aids and hearing exams
  • Deductibles, coinsurance, or copayments when health care services are provided (Medigap plans can cover all or a portion of these charges).

It is important to note that some of the aforementioned services are covered under some Medicare Advantage plans.  Prior to the ACA, preventive screening exams generally were not covered by Medicare, but numerous screening tests are now covered under Medicare B, thanks to the ACA.

To help with the out-of-pocket costs in Original Medicare, enrollees may consider Medigap (Medicare supplement insurance) policies and Medicare D (prescription drug) plans.

To cover long-term care, Medicare enrollees can purchase private long-term care insurance.