Medicare doesn't cover eye exams for eyeglasses, long-term care, cosmetic surgery, massages, routine physical exams, most dental care, or provider services. Here's a breakdown of what the four parts of Medicare cover (and don't cover), plus some other things that Medicare helps pay for. Medicare doesn't cover annual physical exams or routine physical exams. This may seem like a lack of vision, as annual physical exams are usually recommended as a preventive measure to prevent more serious medical problems through early detection.
Medicare does cover a Medicare wellness visit, also called a wellness exam. This type of consultation is an evaluation of your general health and well-being. If you save money on an HSA before you sign up for Medicare, you can request tax-free distributions at any age to reimburse for exams, eyeglasses, contact lenses, prescription sunglasses and other out-of-pocket expenses related to eye care. Medicare Part A (also known as hospital insurance) can generally cover inpatient hospital care, nursing facility care, nursing home care, palliative care, and home health care. Original Medicare generally doesn't cover the cost of a nursing home, assisted living facility, or long-term care facility.
Medicare Part B (also known as health insurance) provides coverage for preventive and medically necessary care services. Medicare covers most of the healthcare needs of older Americans, from hospital care and doctor visits to laboratory tests and surgery. For example, Medicare doesn't cover breast augmentation for cosmetic reasons, but reconstructive surgery after a mastectomy does. In addition, the Department of Health and Human Services finalized rules in April 2024 to review how Medicare Advantage customers obtain prior approval for care.
Medicare covers a wellness visit once every 12 months (a full 11 months must have passed since your last visit), and you are eligible for this benefit after receiving Part B for at least 12 months. Medicare Part B (health insurance) helps cover the cost of medically necessary durable medical equipment if your doctor prescribes it for use in your home. Medicare provides coverage for some skilled nursing services, but not for custody care, such as help with bathing, dressing and other activities of daily life.
