Original Medicare provides a strong foundation of medical and hospital coverage, but it has notable blind spots. Dental care, routine eye and hearing care, prescription medications, long-term care, international care, and certain preventive or alternative treatments are often not covered, leaving beneficiaries potentially vulnerable to high expenses. 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 generally doesn't cover routine eye exams or eyeglasses (exceptions include an annual eye exam if you have diabetes) or eyeglasses after undergoing certain types of cataract surgery.).
However, some Medicare Advantage plans provide eye coverage, or you may be able to purchase a separate supplemental policy that provides eye care. In addition, some Medicare Advantage plans cover emergency care abroad. Or you can buy a travel insurance policy that covers some medical expenses while you're outside the U.S. UU.
It can even cover an emergency medical evacuation, whose transportation aboard a medical plane or helicopter can cost tens of thousands of dollars. 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 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. 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 provides coverage for some skilled nursing services, but not for custody care, such as help with bathing, dressing and other activities of daily living. Medicare Part B (health insurance) helps cover the cost of medically necessary durable medical equipment if a doctor prescribes it for use in the home.
Without additional coverage, many seniors are forced to pay out of pocket for many of the common services that original Medicare doesn't cover. 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. Original Medicare usually doesn't cover the cost of a nursing home, assisted living, or a long-term care facility. Medicare Part B (also known as health insurance) provides coverage for preventive and medically necessary care services.
You may also consider purchasing separate dental and eye care policies if you want to cover these aspects but don't want to pay for a Medicare Advantage plan. However, in reality, there are significant gaps in what Original Medicare will pay, which can lead to unexpected out-of-pocket costs for routine care and specialty services. Original Medicare, which includes Part A for hospital coverage and Part B for medical services, forms the backbone of health insurance for more than 68 million retired Americans today. 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...
