5 things that are excluded from Medicare plans
Medicare provides coverage for the healthcare expenses of most seniors and disabled persons in the country. But it does not cover every aspect of healthcare. In general, the basic plans such as Plan A and Plan B cover partial costs associated with hospital care, doctor visits, and lab tests under certain terms and conditions. People usually have to take on additional plans, such as Medicare Advantage, to cover additional expenses that are not included in original plans.
Routine physical exams
Neither Plan A nor Plan B of Medicare provides coverage for regular physical examinations by a primary care doctor. Unless the examination is related to the treatment or diagnosis of any health disorder, the basic Medicare plans will not cover the expenses. But it does cover routine checkups in some form as a part of wellness checks or preventive care. This includes a one-time health monitoring checkup in the first year of enrolling for Medicare Part B. For the following years, the expenses of annual wellness visits are covered.
Hearing aids
Medicare plans, including most Medicare Advantage plans, do not cover expenses for hearing aids, which also include routine hearing exams. However, coverage is provided for hearing tests prescribed by primary care doctors to diagnose any ear condition. In addition, coverage is provided for the treatment of some ear-related health issues. Some Medicare Advantage plans may cover hearing aids. To know which ones, it is best to contact the insurance provider.
Eye exams and opticians
The basic Medicare plans do not provide coverage for routine eye exams, prescription glasses, contact lenses, and appointments with opticians. There are a few Medicare Advantage plans that may cover these expenses. However, these plans keep on changing from time to time. Partial coverage is provided for the treatment of a few eye-related health conditions, such as cataract surgery. The best way to know which Advantage plans cover these costs is to contact individual insurance providers.
Dental care
Medicare does not cover a majority of the basic dental care expenses. These include dental procedures and supplies such as tooth extractions, cleanings, dental plates, fillings, dentures, and dental devices. Most people who need to regularly undergo dental work eventually take private dental insurance. But if a dental service has to be done as a part of another healthcare procedure that is already covered, Medicare may pay for this. Also, Part A provides coverage for hospital stays that might be required for emergency dental work.
Long-term nursing home care
Medicare Part A pays for nursing home care and hospital stays. In addition, coverage is provided for rehabilitation facilities that may be required as part of inpatient physical therapy after major surgery. However, long-term nursing home care or custodial care, such as assisted living facilities, are not included in Medicare or Medicare Advantage plans.