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Retirees know there are many services that Medicare won't cover, like weight-loss drugs or ED pills. But there are always exceptions, it seems, and a menu of caveats on what Medicare will or won't cover for Parts A, B, C, and D.
It can be hard to make sense of the confusing alphabet soup.
If you're budgeting for retirement, here's a quick, simple guide of what your Part B will pay for so you can plan accordingly and avoid paying out of pocket and other surprising financial mistakes.
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Eye exams
Forget what you've heard; Medicare will cover eye exams.
However, it doesn't cover every type of eye exam. Medicare Part B will not cover "eye refractions" or exams to update your glasses or contact lens prescription. But it will cover wellness exams to screen for medical conditions such as cataracts or glaucoma.
Eyeglasses or contact lenses — in some circumstances
Like eyeglass exams and prescription lens fittings, Medicare Part B will pay for prescription eyeglasses if they're prescribed following cataract surgery that implants an intraocular lens.
While this sounds like a narrow rule, the procedure is more common than many think. According to the University of Florida College of Medicine, by age 80, nearly half of all Americans have cataracts, and nearly four million cataract surgeries are performed every year.
That includes frames, replacement lenses, and fittings.
If you need vision correction unrelated to cataracts, you'll pay the full retail cost unless you have a Medicare Advantage plan or separate vision insurance that includes eyewear benefits.
Short-term nursing care
Most people know that Medicare does not cover long-term care like nursing homes and assisted living facilities.
But Medicare will cover short-term skilled nursing facility (SNF) care. This includes skilled nursing care in a semi-private room, medication support, medical supplies and equipment used in the facility, ambulance transportation, speech-language therapy, and often physical and occupational therapy.
SNF coverage applies if you first have a "qualifying inpatient hospital stay" of at least three days in a row.
Time spent waiting in the ER doesn't count, even if you're there under observation overnight. Medicare starts counting from the day you were admitted as an inpatient and does not count the day of your discharge.
Additionally, if your doctor is part of the "Skilled Nursing Facility 3-Day Rule Waiver," you may not need a minimum 3-day inpatient stay to qualify for SNF. Always ask your facility (preferably someone in billing, not your nurse) and contact your plan.
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Annual wellness visit
The standard "annual physical" that many people received before age 65 isn't covered under Medicare.
Instead, Part B provides a free Annual Wellness Visit, which focuses on risk assessments and care planning rather than physical exams. If you request a traditional physical, expect to pay out of pocket for the service.
Hearing tests
Hearing aid exams and fittings aren't covered under Medicare Part B, but your plan often covers diagnostic tests to evaluate hearing loss related to balance or fall risk.
The cost of the hearing device will fall squarely on your shoulders, though. Some seniors find solid deals at warehouse clubs like Sam's Club or Costco. Additionally, consider Medicare Advantage plans that cover more hearing-related needs.
Hearing issues are already expensive enough — retail prices for hearing aids often run into the thousands — so make sure you are taking advantage of the limited auditory care that your Part B will provide.
Cardiovascular disease screenings
This is a tricky one. You may have heard otherwise, but Medicare Part B will cover cardiovascular screenings, but it's once every five years, and that's if your physician agrees to accept the Medicare assignment.
If your doctor or health provider group does not participate in Medicare, then Part B will not pay for the service, even if the screening itself would typically be covered.
Always check in advance to avoid an unexpected bill. Consider supplemental insurance that will cover the service, or schedule with a different provider in a participating clinic.
Foot care
No, Medicare Part B won't pay for general hygiene and preventative maintenance, including nail trimmings, corn or callus removal, toenail fungus, and other common foot ailments, even though this type of daily care is a struggle for many older adults.
But Medicare does cover many podiatry and foot-care services, such as treatment for diabetic-related nerve damage and bunions, hammertoe, or heel spurs.
Some chiropractor visits
Medicare will actually cover some chiropractor visits, depending on the condition treated. While it won't cover exams, X-rays, massage therapy, or acupuncture, it can cover back adjustments.
Part B will pay for manual spinal manipulation to correct a vertebral subluxation or spinal misalignment.
Watch out for pricing as these services are often bundled. Many retirees receive an unexpected bill from the chiropractor, assuming their visit was covered because it included spinal manipulation.
Select dental services
Medicare does not cover most dental services, but it does cover some. The plan will pay for dental work related to a covered medical procedure, such as pre-surgery dental work, dental splints, or dental care during cancer treatment.
For regular dental care, such as cleanings, fillings, and root canals, you must rely on Advantage plans with dental benefits or pay out of pocket.
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Emergency transportation services — by land or air
Medicare Part B will cover an ambulance ride or other ground transportation to the nearest appropriate medical facility if traveling in any other vehicle could endanger your health, and you need medically necessary services in a skilled nursing facility, hospital, or critical care hospital.
Your coverage will even pay for emergency air transportation via airplane or helicopter if you need more rapid transport than ground options can provide.
These rules are important to know, as Medicare will not pay for ambulance services in what it deems our "non-emergency situations" or if you ask the EMT to bring you to your preferred hospital that's just down the road.
Bottom line
Medicare Part B covers many essential services, but with caveats that can catch retirees off guard. Understanding what is and is not covered can help you plan more accurately for future health expenses and stretch your retirement dollars further.
Before you book care, call the provider's office to confirm their Medicare participation so you don't get stuck flat-footed with a hefty bill.
If you haven't done so yet, now's a good time to explore long-term care insurance and supplemental coverage options so you can compare plans and lock in the best rates.
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