Taking advantage of Medicare is one of the best ways to stretch your retirement dollars further. The government-funded insurance program helps you pay for prescription medication, routine doctor's visits, and short-term hospital stays. However, there are some crucial things Medicare doesn't cover — including several common senior-specific medical issues that you might have assumed Medicare pays for.
Keep reading to learn more about the medical expenses Medicare doesn't cover and how you can still access crucial services that aren't covered.
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Non-medical long-term care
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While Medicare Part A helps you pay for short-term hospital stays after you meet your deductible, it doesn't cover long-term care. This means that if you plan to eventually move into a nursing home, you'll need to find an alternate way to pay for it, such as Social Security income, Medicaid, or your own retirement savings.
In 2023, a semi-private room in a nursing home could set you back upwards of $8,000 per person per month, according to U.S. News & World Report — so if you anticipate moving into a nursing home, start budgeting for it early on in your retirement.
Personal care assistance
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As they age, many people find they need extra assistance to perform day-to-day tasks like cleaning, cooking, bathing, and dressing. Although certain at-home nursing services may be covered by your Medicare plan, custodial tasks like these aren't covered by Medicare, which means you'll have to pay for them out of pocket.
Eye exams
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Like most private health insurance companies, Medicare doesn't cover annual eye exams. If you don't want to pay out of pocket for annual exams, consider investing in a separate vision insurance policy, many of which fully cover annual optometry exams.
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Most prescription glasses and contact lenses
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For the most part, Medicare doesn't cover glasses or contacts. A separate vision health insurance policy should help you pay for the cost of new frames, lenses, and contacts.
However, Medicare Part B does help cover one set of contacts or glasses if you have cataract surgery, as long as that surgery involves implanting an artificial lens. But, there's a catch: Medicare will only help cover post-surgery lenses or glasses once you've met your yearly deductible, and you'll still pay 20% of the cost yourself out of pocket.
Hearing aids
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Even though many seniors end up needing hearing aids as they grow older, Medicare won't help cover the cost — either of hearing aids themselves or the ear exams necessary to fit them. If you opt for private insurance through Medicare Advantage, you could find a plan with hearing aid coverage. Otherwise, plan to pay for hearing aids out of pocket.
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Adult day care services
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Seniors struggling with memory disorders like Alzheimer's or dementia often spend daytime hours at licensed adult day care centers, which help ensure they're taken care of while giving family caretakers a bit of a break. According to AARP, the median cost for adult day care is around $1,700 a month, which comes to about $80 a day.
Medicare doesn't cover adult day care costs, but since states regulate adult day cares, you might be able to find financial assistance through state agencies and programs like Medicaid.
Cosmetic surgery
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Medicare won't help you pay for elective cosmetic surgery, though it may cover medically necessary plastic surgery.
For instance, if you have elective (rather than medically necessary) weight loss surgery, Medicare won't help you cover the costs of a post-surgery abdominoplasty. But if your doctor determines that bariatric surgery is medically necessary, Medicare will both help you pay for the surgery and pay for medically necessary abdominoplasty as recommended by your doctor.
Massage therapy
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Original Medicare doesn't cover massage therapy, but you might be able to find a Medicare Advantage plan that covers a certain number of massage therapy visits.
Acupuncture
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Generally speaking, Medicare doesn't cover acupuncture. However, Medicare Part B will cover acupuncture solely to treat chronic lower back pain, and it will only cover 12 visits over 90 days. If your chronic lower back pain shows improvement, you could be approved for an additional eight acupuncture treatments, but Medicare won't pay for more than 20 visits a year.
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Home meal delivery services
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Services like Meals on Wheels deliver hot meals to seniors who have a hard time cooking for themselves or leaving the house due to mobility issues. While Medicare doesn't cover home meal delivery, many of these services strive to make their meals as affordable as possible. For instance, Meals on Wheels typically charges on a sliding scale so you don't have to pay more than you can afford.
Bottom line
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Medicare comes with plenty of perks, but to truly maximize your senior benefits, you'll need to prepare financially for emergencies Medicare can't cover.
Along with planning for ways to manage your Medicare premiums, you'll also want to make room in your budget for supplemental insurance programs, out-of-pocket costs, and long-term care that you're likely to need as you age. Not only can this help prevent you from being caught off guard by these costs, but it can also help you to ensure that you continue to get the healthcare coverage you need in retirement.
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