Services Medicare typically does not cover

Medicare covers hospital stays, doctor visits, and many medical treatments, but it has clear boundaries. Long-term care, dental work, vision care, hearing aids, and most prescription drugs outside Part D are not covered by Original Medicare. Some of these gaps can be filled by supplemental insurance or Medicare Advantage plans, but many cannot—and you will pay the full cost yourself.

The services left out are often the ones seniors need most frequently. A routine dental cleaning, eyeglasses, or a hearing aid can cost hundreds or thousands of dollars. Understanding what Medicare will not pay for helps you plan ahead and know where to look for other payment options.

Key Takeaways

  • Original Medicare does not cover dental care, routine eye exams, eyeglasses, contact lenses, or hearing aids under any circumstances.
  • Long-term care in a nursing home or assisted living facility is not covered by Medicare, though a short skilled nursing stay after hospitalization may be.
  • Prescription drugs are covered only through Medicare Part D, which you must enroll in separately, and many drugs still require you to pay a portion of the cost.
  • Routine foot care, cosmetic surgery, and most physical therapy outside a medical setting are not covered.
  • Medicare Advantage plans may cover some of these services, but coverage varies by plan and by region.

Dental care and vision services

Medicare does not cover routine dental care, dental surgery, or dentures. This includes cleanings, fillings, root canals, extractions, and crowns. If you need dental work, you pay the dentist directly unless you have a separate dental insurance plan through a former employer, a union, or a private dental plan you purchase on your own.

Vision care is also not covered. Medicare will not pay for routine eye exams, eyeglasses, contact lenses, or bifocals. The only exception is one pair of glasses or contact lenses after cataract surgery if Medicare paid for the surgery itself. Some Medicare Advantage plans include dental or vision benefits, but the coverage is usually limited—often a set dollar amount per year rather than full coverage.

Hearing aids and hearing tests

Medicare does not cover hearing aids or the fitting of hearing aids. It also does not cover routine hearing tests. If you need a hearing aid, you will pay the full cost, which typically ranges from several hundred to several thousand dollars per device.

Some Medicare Advantage plans now include hearing aid coverage as a benefit, though this is still uncommon and varies by plan and location. If you are enrolled in Original Medicare, you have no coverage for hearing services. Some states offer hearing aid programs for low-income seniors, and some hearing aid companies offer payment plans or discounts for seniors without insurance.

Long-term care and custodial care

Medicare does not cover long-term care in a nursing home or assisted living facility. This is one of the largest gaps in Medicare coverage and one that catches many families off guard. Medicare will pay for a skilled nursing facility for up to 100 days, but only if you were hospitalized for at least three days first and only if you need skilled nursing or rehabilitation—not just help with daily activities.

Once that 100-day benefit ends, you pay for nursing home care yourself. If you cannot afford it, you may eventually become may be able to access for Medicaid, which does cover long-term care, but Medicaid has strict income and asset limits. Long-term care insurance, purchased while you are still healthy, is one way some people plan for this cost, though premiums can be expensive.

Prescription drugs without Part D enrollment

Original Medicare Part A and Part B do not cover prescription drugs. To have any drug coverage, you must enroll in Medicare Part D, a separate prescription drug plan you choose from private insurers. Part D is optional, but if you do not enroll when you first become may be able to access, you may pay a penalty for the rest of your life.

Even with Part D, you do not get free drugs. You typically pay a monthly premium, a yearly deductible, and a copay or coinsurance for each prescription. Some drugs are not covered at all, and you must pay the full price. If you cannot afford your medications, talk to your doctor about generic alternatives or ask the drug manufacturer about patient information programs.

Routine foot care and other excluded services

Medicare does not cover routine foot care, including nail trimming and callus removal, unless you have diabetes and the care is related to your diabetes. It also does not cover cosmetic surgery, weight loss surgery (unless medically necessary for a specific condition), or most physical therapy outside a medical setting.

Acupuncture, chiropractic care, and massage therapy are not covered. Some alternative treatments may be covered if they are ordered by a doctor as part of treatment for a covered condition, but this is rare. Homemaker services, meal delivery, and transportation to medical appointments are also not covered by Medicare, though some community programs or Medicaid may help.

How Medicare Advantage plans differ

If you are enrolled in a Medicare Advantage plan (Part C) instead of Original Medicare, your coverage may be different. Many Advantage plans include dental, vision, or hearing benefits that Original Medicare does not. However, these benefits vary widely by plan and by region. One plan in your area might cover dental cleanings twice a year; another might cover only a set dollar amount toward dentures.

Before you switch to a Medicare Advantage plan, compare the specific benefits offered. A plan that covers dental care in one county may not offer it in the next county over. You can review plan details on Medicare.gov or call 1-800-MEDICARE to ask about specific services. If you switch plans during the annual enrollment period, make sure the new plan covers the services you actually need.

Frequently Asked Questions

Does Medicare cover any dental work at all?

No. Original Medicare does not cover any dental services—not cleanings, not extractions, not emergency dental care. The only way to have dental coverage is through a separate dental plan, some Medicare Advantage plans, or Medicaid in your state.

What if I need glasses after cataract surgery?

Medicare will pay for one pair of eyeglasses or contact lenses after cataract surgery if Medicare paid for the surgery. After that one pair, you pay for any additional glasses or contacts yourself.

Can I get hearing aids through Medicaid if I cannot afford them?

Medicaid coverage of hearing aids varies by state. Some states cover them; others do not. Contact your state Medicaid office to ask what is covered where you live. Some states also have separate hearing aid programs for low-income seniors.

If I move to a Medicare Advantage plan, will it cover my prescriptions?

Medicare Advantage plans must include prescription drug coverage, so yes—but the drugs covered and the costs you pay may be different from Part D. Review the plan's drug formulary (the list of covered drugs) before you enroll to make sure your current medications are included.

What happens if I cannot pay for services Medicare does not cover?

Talk to your doctor or the provider about payment plans or sliding scale fees based on income. Some nonprofits and community health centers offer services on a sliding scale. For prescription drugs, ask about manufacturer information programs. For dental or vision care, look for dental schools or vision centers that offer reduced-cost care.