For individuals aged 65 and above and for those living with certain debilitative health conditions, Medicare is the ultimate lifesaver for health-related expense coverage. While Medicare Parts A, B, or Medicare Advantage cover several expenses, there are certain elements that fall out of their scope. Therefore, if seniors spend their money on the healthcare operations mentioned below, they will need alternative providers to cover them. Here are some things Medicare does not include in the plans:

Hearing aids
Original Medicare, the first half of the federal healthcare scheme, does not cover hearing exams or hearing aids. While Medicare Advantage, the other half, generally offers partial coverage for the same, buying additional insurance from a private provider is beneficial to offset the complete costs of a hearing examination, treatment, or the purchase of hearing aids from one’s local dispensary.

This applies even to treating auditory issues such as tinnitus, a disorder in which individuals feel a constant ringing sensation in their ears, which is not covered by either Original Medicare or Medicare Advantage.

Overseas healthcare
A common and truly wallet-shattering mistake that people with Medicare coverage make is assuming that their card covers the healthcare costs incurred in foreign lands. Here’s the key fact: Medicare’s validity goes away when a person leaves the country or territory. In terms of water transport, Medicare’s reach lasts only up to six hours away from a port on a cruise ship if one is traveling in US waters.

For this reason, one needs to know exactly what kind of healthcare treatment or services they will be using abroad before buying the requisite health insurance coverage to offset the costs. In this way, one can save the money they would otherwise end up losing abroad on treatment and healthcare purchases.

Dental care
As is the case with hearing aids and examinations, Original Medicare does not cover dental services. These include X-rays, denture implants, fillings, and cleanings. Although Medicare Part A covers certain dental services while one is admitted to a hospital, most costs are out of Medicare’s scope. Certain Medicare Advantage plans cover specific preventive and diagnostic services, such as routine cleanings and X-rays. However, as specified earlier, it is recommended to buy separate dental or healthcare insurance for dental procedures like fillings, crown fittings, root canal operations, implants, and dentures.

One workaround in such a situation is to check if one has access to a Health Savings Account (HSA) if they have a high-deductible health plan. HSAs ensure that customers save money spent on healthcare expenses in retirement, including for accrued dental services. Moreover, people with HSAs can withdraw funds from it on a tax-free basis for qualifying expenses. If there is a point of contention, one cannot contribute to a Health Savings Account after applying for Medicare. Therefore, starting early is recommended for dental expense coverage.

Long-term care
As people get older, the chances of them needing long-term healthcare increase exponentially. A study found that people turning 65 have a 70 percent chance of being admitted to a healthcare center for multiple weeks or months. As one can imagine, using healthcare residences for a long duration can result in hefty bills. Unfortunately, long-term care is not covered under Original Medicare if that is the only care one needs in a healthcare facility.

While Medicare does cover skilled nursing facility expenses only if a doctor recommends it after a qualifying three-day inpatient hospital stay, there are conditions to that as well. For instance, Medicare will cover the first 100 days of care along with daily coinsurance charges. After that period lapses, the patient and their family will be responsible for all the costs.

When it comes to Medicare Advantage, there may be specific additional (yet limited) benefits and coverages. For example, some Medicare Advantage plans provide in-home help, but as stated earlier, the expense coverage is not much. Additionally, relatively few plans and insurance providers offer coverage. After all, long-term healthcare expenses are a huge financial risk for them too.

Chiropractic care
Acupuncture and chiropractic services fall under the same bracket when it comes to Medicare coverage. This basically means that the federal healthcare coverage plan, in most cases, cannot be used for either of the two services. Medicare only tends to cover chiropractic services in very specific circumstances. For example, if the care seeker has to treat a vertebral subluxation (a health condition in which there is extensive pressure on one’s nerves), then Medicare can step in to salvage the situation.

The same exclusivity applies to acupuncture services too. If a doctor verifies and orders acupuncture as a part of a lower back procedure, Medicare may cover it. In such cases wherein acupuncture is covered, only 12 sessions within 90 days or 20 annual visits under chronic low back pain will be allowed for coverage.

Deductibles and co-pays
In Original Medicare, both Part A (that deals with hospital insurance) and Part B (health insurance) necessitate out-of-pocket spending for people in the form of coinsurance and deductibles. Therefore, certain needs can cause people to spend a lot on health and hospital expenses. Essentially, there is no out-of-pocket spending cap when it comes to Original Medicare.

In Medicare Advantage, private insurance companies offer coverage. In such plans, the patient will be responsible for specific deductibles, coinsurance, or copays when they seek healthcare services. Unlike Original Medicare, there is an out-of-pocket expenditure cap when it comes to Medicare Advantage plans. However, the limit is set at around $8,300 (as of 2023).

Routine vision care
Medicare also does not cover routine eye exams or the purchase of glasses from an eye-care store. The only exceptions to this are annual eye exams for patients who have diabetes or purchase eyeglasses after a cataract surgery.

Apart from these, other expenses, such as routine foot care or cosmetic repair surgery costs, are also not covered under Medicare.