Agency on Aging

Understanding What Medicare Does Not Cover

Medicare is a health insurance plan available primarily to individuals who have worked and paid Medicare taxes. It has vast coverage and has improved healthcare access for millions of people over multiple decades, but it does not cover everything. Many health-related services that we rely on are not covered by Medicare. Therefore, it is important that you know what Medicare DOES NOT cover, so you can make alternate arrangements for services you may need that are not covered by Original Medicare. Below is a list of the services NOT covered by Original Medicare: 

  • Long-term care (also called custodial care)  

  • Most dental care 

  • Dentures 

  • Eye exams (for prescription glasses) 

  • Cosmetic surgery   

  • Massage therapy 

  • Routine physical exams 

  • Hearing aids and exams for fitting them 

  • Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care) 

Covered items or services you get from an opt-out doctor or other provider (except in the case of an emergency or urgent need) Some of these services are available to people who choose to opt out of Original Medicare and purchase a managed care plan. It is up to you to select the type of Medicare plan that works best for you. Some people prefer to remain with Original Medicare and add additional insurance coverage for things like dental through a private insurance provider. There are many choices you can make to maximize your insurance coverage and ensure you have the best package of benefits for your individual situation. There is no one best option. Each option should be tailored to your needs. If you need help reviewing your options, contact a CHOICES, certified, health insurance counselor 800 994 9442.