Medicare covers many health care needs, but not everything. The insurance doesn’t pay for cosmetic procedures, alternative medicine such as acupuncture and most durable medical equipment.
Private insurers offer Medicare Advantage plans that include coverage for things Original Medicare doesn’t. These are a good option for some seniors. But most still need to be prepared for big expenses that aren’t covered.
1. Dental Care
The reason dental care is not covered by Medicare has to do with the way the program operates and how much it costs. Medicare only spends about 1% of its budget on dental services, according to the Kaiser Family Foundation. Adding dental care to the program would cost significantly more, and that could raise concerns about how the benefit might be used by beneficiaries.
Original Medicare pays for some dental services that are closely related to other covered medical services (like oral surgery before certain cardiac procedures). Some people enrolled in Medicare Advantage plans have access to more extensive dental benefits, but the majority of these plans impose annual dollar limits on those benefits.
Nearly 24 million people enrolled in Medicare—or half of all people enrolled in the program—don’t have dental coverage. But a number of proposals have been introduced that could expand coverage to include more routine visits, fillings, and dentures. These proposals vary, but most are based on the belief that dental care is a necessary component of overall health and well-being.
2. Eye Care
Eye care can be one of the most important parts of primary healthcare. Blindness can be devastating to a person, their family and the community. Primary eye care workers are essential for prevention and early treatment of ocular disease, and help patients avoid expensive secondary and tertiary care.
Eye exams can also detect serious underlying medical conditions like diabetes and hypertension at the earliest stages, giving them the best chance to save sight and improve quality of life. Many Medicare Advantage plans offer vision coverage, and you may be able to buy separate supplemental insurance policies that cover routine exams and eyeglasses.
Taking good care of your eyes means eating well, getting plenty of rest and limiting screen time. It also includes consuming eye-friendly nutrients such as lutein and zeaxanthin, vitamin C, vitamin E, zinc and omega-3s. These nutrients can also help prevent certain ocular diseases, such as cataracts and age-related macular degeneration. Many of these nutrients can be found in green leafy vegetables, fruits and nuts.
3. Hearing Aids
Hearing loss can lead to miscommunication and feelings of alienation from social events, which can have a negative impact on mental health. But many seniors can’t afford to purchase hearing aids — which often cost thousands of dollars — because they’re not covered by Medicare.
However, Medicare Advantage plans – which are private insurers that offer coverage alternatives to Original Medicare Parts A and B – may cover hearing aids or exams to fit them. And some Medigap plans also offer coverage.
If you opt for a plan that offers hearing-related coverage, make sure to shop around and compare prices. Some of these private Medicare Advantage plans have pre-set rates for hearing providers, which can save you money. And some have nationwide networks, while others are confined to a single state. Purchasing hearing aids from Costco or other wholesale retailers may also help you reduce costs, as they’re typically less expensive than audiology offices. In addition, some employers have programs that allow retirees to use flexible spending accounts or health savings accounts to pay for hearing care and hearing aids.
4. Long-Term Care
Long-term care is the help you may need to stay at home or in an assisted living facility if you develop a chronic or debilitating condition. This type of assistance is usually custodial in nature and includes activities such as bathing, dressing, eating, moving around (mobility), using the toilet, managing bladder and bowel incontinence and transferring (getting out of bed or a chair). Long-term care is not covered by regular health insurance or Medicare. However, you may qualify for coverage through Medicaid if your assets are low enough. Purchasing a long-term care policy is a major financial decision, so it is important to understand the cost and features before making a purchase.
It is not uncommon for older adults to need some form of long-term care services. Unfortunately, these services are not cheap, and the costs can quickly drain your retirement savings and dwindle your family's income. Long-term care is not covered by Medicare, but you can prepare for these expenses with a long-term care insurance plan.
