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Medicare Doesn't Cover These 4 Expenses That Could Total Over $100K

Even with Medicare, retirees can face steep out-of-pocket costs — here's what's not covered and how to prepare for it.

By Adam Palasciano

Edited by Laura Hohenstein

Updated Nov. 6, 2025

Medicare covers a lot — but not everything. Many retirees are surprised to discover that essential health services like dental, vision, hearing, and long-term care are largely excluded. Those gaps can add up quickly, and may total more than $100,000 over time.

If you want to make the right moves toward protecting your savings, it's crucial to understand what Medicare doesn't pay for and plan for those costs.

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1. Eye care

Medicare doesn't cover routine vision care, and that can get expensive fast. A standard eye exam averages about $136 without insurance, according to Vision Center. At big box stores and retail optical chains, you can expect to pay between $70 and $105, while at private optometry offices, you can expect to pay between $100 and $200+.

Readers.com reports that a pair of glasses costs about $350 on average without insurance. Medicare may cover treatment for eye injuries or certain disease screenings, but standard exams and eyewear are fully out-of-pocket.

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2. Dental care

Dental expenses are one of the biggest blind spots in Medicare coverage. Original Medicare doesn't pay for cleanings, fillings, crowns, or dentures — all of which can become necessary with age. The average cleaning costs $75 to $200, and a cavity filling ranges from $50 to $250, depending on the number of teeth and the type of material used. Major work costs much more: a root canal averages $1,165, and dentures can range from $350 to $12,450, depending on the type.

While these numbers are daunting, you do have options. Some Medicare Advantage plans, offered through private insurers, cover basic dental care. If you stay with original Medicare, you'll likely need a separate dental budget or look into supplemental dental insurance.

3. Hearing aids

Hearing loss affects many older Americans — yet Medicare doesn't cover the cost of hearing aids or routine hearing exams. Depending on the model, a single hearing aid can cost $1,000 to $6,000.

If your hearing loss stems from a medical condition or injury, Medicare may cover diagnostic exams or treatment. However, the hearing devices themselves — and most fittings or adjustments — come out of your own pocket. Over time, those costs may easily surpass $10,000.

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4. Long-term care

Perhaps the most expensive gap in Medicare coverage is long-term care. These services include nursing homes, assisted living, and in-home help with everyday tasks like bathing and dressing — none of which are considered "medical" under Medicare rules.

According to CareScout, the average annual cost of a private nursing home room can exceed $100,000, and a home health aide can cost more than $70,000 per year (depending on which state you live in).

Medicare only covers short-term stays at skilled nursing facilities following hospitalization, so retirees often need to pay out of pocket, use long-term care insurance, or rely on Medicaid if they qualify.

How to prepare your finances to afford extra medical expenses in retirement

Knowing what Medicare doesn't cover is just the first step — planning for those costs is key. Start by setting aside funds in a dedicated health savings account (HSA). Consider building a financial cushion that covers at least one year of potential medical expenses, especially if you have chronic conditions.

Meeting with a financial planner can help you estimate costs and prioritize where to allocate funds. Some retirees may even choose to downsize their homes or rework their investment portfolios to free up money for future healthcare needs.

1. Open and start funding an HSA

A Health Savings Account (HSA) can be a powerful tool for covering uncovered medical costs. You can use an HSA to pay for dental work, vision exams, and hearing aids — all tax-free. If you're still working and enrolled in an eligible high-deductible health plan, start contributing now.

The IRS sets annual limits on HSA contributions — for 2025, you can contribute up to $4,300 if you're covered by a high-deductible health plan as an individual, or $8,550 if you have coverage for your family. In 2026, those same figures will increase to $4,400 and $8,750, respectively. At age 55, individuals can contribute an additional $1,000 per year.

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2. Use funds from Social Security or retirement accounts

If you've built up savings in a 401(k), IRA, or other retirement account, you can earmark part of those funds for healthcare expenses. Some retirees may also use a portion of their Social Security benefits for this purpose.

Keep in mind, though, that withdrawals from traditional retirement accounts are generally taxed as income, so plan accordingly.

3. Explore supplemental coverage options

In addition to Medicare Advantage, you might consider Medigap policies or stand-alone insurance plans for vision, dental, and hearing. These plans can help bridge the gap between what Medicare covers and what you actually need.

While they do come with premiums, supplemental policies may save you thousands over time — especially if you anticipate ongoing dental or vision expenses. Comparing quotes and coverage details each year ensures you're not overpaying or underinsured.

Bottom line

Medicare provides essential protection, but its coverage gaps can lead to major out-of-pocket expenses for retirees. From long-term care to hearing aids and routine dental visits, these costs can easily exceed $100,000 over time if you're not prepared.

Taking proactive steps now — such as funding an HSA, reviewing supplemental coverage, and setting aside dedicated savings — can help you stay financially secure and focused on what truly matters: enjoying a stress-free retirement.

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