What isn't covered by Medicare?

Original Medicare (Parts A & B) generally doesn't cover routine dental, vision (glasses, exams), hearing aids, long-term custodial care, most cosmetic surgery, or prescription drugs (that's Part D). It also excludes services like acupuncture, most chiropractic care, private-duty nursing, and personal comfort items in hospitals (like TVs). Medicare Advantage (Part C) plans often fill these gaps with extra benefits like vision, dental, and hearing coverage, but it depends on the specific plan.


What is typically not covered by Medicare?

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine physical exams. Cosmetic surgery.

What are the 5 treatments not covered by Medicare?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.


What does Medicare not pay for seniors?

Original Medicare (Parts A & B) generally doesn't cover routine dental, vision (like eyeglasses/contacts), hearing aids, most long-term care, cosmetic surgery, or most prescription drugs, and it excludes personal/custodial care (bathing, dressing) if it's the only care needed, but Medicare Advantage Plans (Part C) or Part D plans often fill these gaps with extra benefits like dental, vision, and drug coverage, though you pay premiums. 

Does Medicare cover anything 100%?

No, Original Medicare (Part A & B) does not cover 100% of costs; it typically pays about 80% after deductibles, leaving you with 20% coinsurance for many services, plus gaps like dental, vision, and most drugs, requiring you to pay out-of-pocket or get supplemental coverage like Medicare Advantage (Part C) or Medigap. Some preventive services are covered at 100%, but most care has cost-sharing. 


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What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

Is Medicare alone enough?

No, Original Medicare (Parts A & B) typically isn't enough because it doesn't cover prescription drugs (needs Part D), has no out-of-pocket spending limit, and misses routine dental, vision, and hearing care, leading most beneficiaries to add Medigap (Supplement) or choose Medicare Advantage (Part C) for comprehensive coverage. Deciding what's "enough" depends on your health, budget, and comfort with risk, as Original Medicare leaves significant costs to you. 

What are the four things Medicare doesn't cover?

Medicare doesn't cover everything: What you need to know
  • Routine dental exams, most dental care or dentures.
  • Routine eye exams, eyeglasses or contacts.
  • Hearing aids or related exams or services.
  • Most care while traveling outside the United States.
  • Help with bathing, dressing, eating, etc.


Is it better to go on Medicare or stay on private insurance?

Neither Medicare nor private insurance is universally "better"; the best choice depends on individual needs, but Medicare often offers lower overall costs and simplicity for seniors, while private insurance excels in covering dependents and potentially offering more choice with networks/out-of-pocket caps, though at higher premiums. Medicare boasts lower admin costs and standardized coverage, but Original Medicare lacks an out-of-pocket maximum, a feature typically found in private plans and Medicare Advantage (Part C). 

Does Medicare pay for a colonoscopy?

Yes, Medicare (Part B) pays for screening colonoscopies, covering 100% of costs if your doctor accepts assignment and no polyps are found, though you pay 15% if they remove tissue (making it diagnostic); frequency depends on your risk, generally every 10 years (average risk) or 24 months (high risk). 

What medications will no longer be covered by Medicare?

Drugs never covered by Medicare

Drugs for anorexia, weight loss, or weight gain (i.e., Xenical®, Meridia, phentermine HCl, etc.) Drugs that promote fertility (i.e., Clomid, Gonal-f, Ovidrel®, Follistim®, etc.) Drugs for cosmetic purposes or hair growth (i.e., Propecia®, Renova®, Vaniqa®, etc.)


What blood tests does Medicare not cover?

Medicare generally doesn't cover blood tests that aren't medically necessary, such as routine wellness panels, employment-required tests, elective tests for general curiosity, or experimental markers, though it does cover specific preventive screens (like PSA) and medically indicated diagnostic tests. You'll likely pay out-of-pocket for tests ordered without a specific diagnosis, tests done too frequently, or those for general "peace of mind," but your doctor should give you an Advance Beneficiary Notice (ABN) if a test isn't covered. 

Does Medicare cover dental and vision?

NARRATOR: Medicare Part A and part B do not provide coverage for dental, vision and hearing. The icons of the toothbrush, eye exam, and human ear appear. All three of them have a red X marked overtop of them.

What prescriptions are not covered by Medicare?

Medicare does not cover:
  • Drugs used to treat anorexia, weight loss, or weight gain. ...
  • Fertility drugs.
  • Drugs used for cosmetic purposes or hair growth. ...
  • Drugs that are only for the relief of cold or cough symptoms.
  • Drugs used to treat erectile dysfunction.
  • Prescription. ...
  • Non-prescription drugs (over-the-counter drugs)


Does Medicare cover prescription eyeglasses?

No, Original Medicare (Parts A & B) generally does not cover routine eye exams or prescription eyeglasses/contacts, but it does cover one pair of standard glasses or contacts after cataract surgery with an intraocular lens implant, plus some medically necessary vision care for conditions like glaucoma or diabetes. For routine vision coverage, you'll need a Medicare Advantage (Part C) plan or a separate vision insurance policy. 

Does Medicare pay for surgery?

Medicare covers most health care needs for older Americans, from hospital care and doctor visits to lab tests and surgery.

Does Medicare cover 100% of hospital bills?

No, Original Medicare (Part A & B) does not cover 100% of hospital bills; beneficiaries pay deductibles, coinsurance, and copays, but you can get full coverage by adding Medicare Supplement (Medigap) plans or choosing a Medicare Advantage plan. Part A covers the first 60 days of a hospital stay (after a deductible), but after that, you pay daily coinsurance, and there's no limit on your total costs unless you have supplemental coverage.
 


What is the best secondary insurance if you have Medicare?

Best Medicare Supplement Insurance Companies in 2026
  • UnitedHealthcare / AARP – Best Plan Pairing: Plan G or Plan N.
  • Cigna Healthcare – Best Plan Pairing: Plan G.
  • Humana – Best Plan Pairing: Plan N.
  • Aetna (CVS Health) – Best Plan Pairing: Plan N.


How to lower Medicare premiums?

To lower Medicare premiums, report income drops from life events like retirement (Form SSA-44), apply for low-income help like Extra Help or Medicaid, use HSA funds for premiums, deduct premiums from taxes, switch to a cheaper Medicare Advantage or Supplement plan, or check if you qualify for Medicare Savings Programs (MSPs) through your state. 

Does Medicare pay 100% for anything?

No, Original Medicare (Part A & B) does not cover 100% of costs; it typically pays about 80% after deductibles, leaving you with 20% coinsurance for many services, plus gaps like dental, vision, and most drugs, requiring you to pay out-of-pocket or get supplemental coverage like Medicare Advantage (Part C) or Medigap. Some preventive services are covered at 100%, but most care has cost-sharing. 


Do I really need supplemental insurance with Medicare?

Supplemental insurance is advisable for those with Medicare to help cover out-of-pocket costs and gaps in coverage, offering financial protection for deductibles, coinsurance, and other medical expenses not fully covered by Medicare.

What is the best health insurance for seniors on Medicare?

There's no single "best" health plan, as it depends on your needs, but top providers for Medicare Advantage (Part C) include Humana, UnitedHealthcare, Aetna, and BCBS, offering diverse benefits like $0 premiums, extra perks, and strong networks, while Medigap (Medicare Supplement) complements Original Medicare by filling gaps, with popular carriers like AARP/UHC, Anthem, and Cigna providing standardized policies (Plans G, F, N), with personalized choices best found via your State SHIP counselor or broker. 

What does Dave Ramsey say about Medicare?

Dave Ramsey's Medicare advice centers on planning ahead, understanding enrollment periods to avoid penalties, using Health Savings Accounts (HSAs) if possible, and supplementing Original Medicare with Medigap or Medicare Advantage (Part C) to cover gaps like dental, vision, and long-term care, stressing that mistakes can be costly and recommending expert advice for personalized choices. 


What is the average cost per month for Medicare?

Medicare costs vary, but for 2026, the standard Part B premium is around $202.90/month, Part A is often $0, Medicare Advantage (Part C) averages low premiums (around $14-$34.50), and Part D (drugs) averages around $34.50-$38/month, but all costs depend on income, plan choice, and work history. Many people pay more for Part B or Part D if they have higher incomes or delayed enrollment. 

Can I drop my Medicare Advantage plan and go back to original Medicare?

Yes, you can drop your Medicare Advantage (MA) plan and return to Original Medicare, typically during the Annual Enrollment Period (AEP) (Oct 15–Dec 7) or the MA Open Enrollment Period (OEP) (Jan 1–Mar 31), though you may qualify for a Special Enrollment Period (SEP) if you move or have other qualifying life events, but be aware you'll need to get a Part D plan and might want a Medigap plan to help with costs.