By the time you turn 65, you probably have a good feel for what health insurance does and doesn’t cover. But Medicare is a different beast — and there are some surprising things that don’t fall under Medicare’s umbrella.
Medicare is the federal government’s health insurance coverage for people age 65 and older, and other people living with disabilities and certain chronic conditions. Here are seven things Medicare doesn’t cover:
1. Deductibles and coinsurance
If you opt for Original Medicare, both Medicare Part A (hospital insurance) and Part B (medical insurance) require out-of-pocket spending in the form of deductibles and coinsurance. If you have medical needs, this can get pricey, and there’s no out-of-pocket cap on Original Medicare spending.
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“Many people on traditional Medicare get a Medigap plan to help cover those costs and make their out-of-pocket costs more predictable,” says Gretchen Jacobson, vice president of Medicare for The Commonwealth Fund, a private foundation with the mission of promoting a high-performing health care system.
If you enroll in a Medicare Advantage plan, which is offered by private insurance companies that contract with the federal government, you’ll also be responsible for any deductibles, copays or coinsurance required when you seek health care. Although there’s an out-of-pocket maximum for Medicare Advantage, that limit can be as high as $7,550 in 2022.
2. Routine dental care
Although Medicare Part A covers some dental services you may get as part of a hospital stay, basic dental care like cleanings, X-rays and fillings aren’t covered. If you want coverage, you’ll have to purchase a separate dental policy.
You may be able to get some coverage by purchasing a Medicare Advantage plan with dental benefits. “But those benefits can be limited, or Medicare Advantage plans can ask you to pay extra for those benefits,” says Lina Walker, vice president of health security for AARP’s Public Policy Institute.
3. Eye exams
Medicare doesn’t cover eye exams for glasses or contacts, or the eyeglasses or contacts themselves. Medicare Part B does cover one pair of glasses or contacts if you have cataract surgery. (After the Part B deductible of $233 in 2022, you’ll pay 20% of costs.)
4. Hearing aids
Medicare also doesn’t cover hearing aids or the exams required for hearing aids. While there’s some language in the Build Back Better Act to add hearing aid coverage to Medicare, the act hasn’t made it through Congress. Medicare does cover diagnostic hearing exams if your doctor thinks …….