This document lists 10 medical issues that are not covered by traditional Medicare, including hospital deductibles, doctor bills, prescription drugs, long term custodial care, routine dentistry, dentures, hearing aids, cosmetic/elective surgery, acupuncture, and some chiropractic services. For many of these issues, supplemental Medigap plans or separate insurance policies can help cover costs that Medicare does not pay.
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10 medical issues not covered by traditional medicare
1. 10 Medical Issues Not Covered
By Traditional Medicare
10 MEDICAL BILLS MEDICARE WILL NOT PAY
2. Hospital
Deductibles
You may be used to
annual deductibles.
That is not the case with
Medicare. Unless you
are readmitted to the
hospital within 60 days
of being discharged for
the same medical
reason, you have to pay
the Medicare hospital
deductible* each time
you are admitted.
* Medigap insurance
will pay this deductible
for you.
3. Doctor Bills
If you are enrolled in part
B of Medicare, it will pay
a portion of your doctor
bills. You will still be
liable for your Medicare B
deductible, 20% of the
Medicare B approved fees
your doctor charges and
100% of your doctor’s fee
in excess of what
Medicare approves. *
Not all, but some
Medigap plans, will pay
these medical bills for
you.
4. Drugs
Neither part A of
Medicare nor part B
will cover prescription
medications. If you
want insurance
coverage for your
prescription drugs, you
will need to enroll in a
Medicare D plan
through an
approved, private
provider. *
Most plans will be
offered by approved
insurance companies or
pharmacies.
5. Long Term
Care
Medicare only pays for
“medically necessary”
care. Medicare does
not pay for “custodial
care.” *
Medicaid is the
government program
that covers Long Term
Care if you qualify for
it. If you do not qualify
in your state, you must
spend your own assets
or use a variation of
Long Term Care
insurance.
6. Routine
Dentistry
Medicare B may cover
your dentist’s bill if
there is a disease that
affects your mouth. It
will not cover routine
dental check-ups. *
* A separate Dental
insurance policy would
be required if you want
dental insurance
during retirement.
7. Dentures
Not only will Medicare
not pay for routine
dentistry, Medicare will
not pay for your
dentures.
8. Hearing Aids
No part of Medicare will
pay for hearing aids or
appointments for fitting
them.
Critical Illness and
Indemnity type Long Term
Care insurance will both
pay a cash benefit that can
be used for hearing aids
under specific conditions.
If your hearing loss is a
normal part of the aging
process and is not caused
by a covered Critical Illness
or Activity of Daily Living,
you will have to pay for
your hearing aid yourself.
9. Cosmetic/Elect
ive Surgery
If the reason for your
hospitalization is purely
cosmetic and
elective, neither
Medicare nor Medicaid
will pay your hospital
bills.
Medicare may pay for
plastic surgery after a
trauma or disease
requires it. It will never
pay for plastic surgery
merely to change your
appearance.
10. Acupuncture
Medicare will only pay
for medical treatment
that is accepted by
western-trained
medical professionals.
Although acupuncture
has been used for
centuries in the far east,
it is not a recognized
treatment by all
western-trained
medical professionals.
11. Chiropractic
Medicare will pay for
chiropractic services
only to treat a
“subluxation” (one or
more of the bones of the
spine have moved out
of position.)
Medicare will not pay
for x-rays, massage
therapy or any other
services that are
provided by a
Chiropractor.