Did you know that Medicare does not cover all of your services regarding health care?
Many people are surprised by this, especially when they receive unexpected big bills.
So today, I will cover eight common services that Medicare does not cover so that you can avoid those surprises and better plan for the health care services you need.
1. Out-of-network expenses.
Depending on whether you joined Original Medicare or Medicare Advantage, there are different rules for which doctors you can see. If you receive care from a provider who is not in your network, your insurance may not pay for these services, meaning you could be expected to pay the full amount.
For that reason, you must understand what your out-of-network rules are to avoid costly surprises in the future.
2. Medicare does not cover all vaccinations.
Different parts of Medicare cover different vaccines. For example, Medicare Part B will cover your flu vaccination, and your Medicare Part D plan covers other vaccines like the shingles vaccine. Your part D drug plan generally covers most vaccinations that Part B doesn’t cover, but your plan may have special rules so it’s important to understand your coverage.
To get a more detailed explanation of what it covers, head on over to read our blog on vaccine coverage.
3. Medicare does not cover long-term care expenses.
Medicare does not cover long-term care (like a nursing home). If you’re going into a nursing home, you will likely pay for that out of your own pocket if you do not qualify for Medicaid.
4. Medicare does not cover pap smears every year.
Now, pap smears are not covered every year but instead every other year (or once every 24 months). However, some people may be covered every 12 months in certain situations, like if they are considered at high risk for cervical cancer. Because of this, I highly recommend that you get clear on how often they are covered for you even before you get those preventative services.
5. Medicare does not cover dental.
The government does not consider dental to be medically necessary, therefore Medicare does not cover it.
There are some Medicare Advantage plans that include dental coverage, however, if you don’t have an Advantage plan that includes it and you want dental insurance, there are plenty of other ways to get those plans.
6. Medicare only covers “medically necessary” vision concerns.
“Medically necessary” vision issues are cataracts, glaucoma, macular degeneration, and things of that nature. They are covered as long as you get that treatment from a doctor who accepts Medicare.
Things like eyeglasses, annual eye exams, and contacts, are not covered by Medicare.
7. Medicare will not cover hearing aids.
Original Medicare does not cover hearing aids. It’s hard to find coverage for hearing aids in general as they are expensive. Medicare will, however, cover if you have an issue with your ears like balance or if your doctor orders a diagnostic hearing test.
8. Overseas travel.
Medicare generally doesn’t cover health care outside of the United States. However, Medicare will cover medical emergencies within a specific timeframe of you being overseas. So please do not assume that Medicare will cover you the same on your overseas trip. Also, if you’re living overseas, I wouldn’t recommend Medicare being your first form of coverage.
Medicare can become extremely costly if you make decisions based on the wrong factors or if you don’t understand how your plan coverage works.
I hear stories of people stuck in the wrong plans for their unique situations every day.
Medicare CAN be excellent health insurance if you make the right decision the first time.
Please be mindful of your situation when making your Medicare decision, as you may not get a second chance to get it right.
To get help with your Medicare decision, you can register for my next free online Medicare workshop today!
