What are 5 items or services not covered by Medicare?

Asked by: Jordi Cummerata  |  Last update: August 15, 2025
Score: 5/5 (60 votes)

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

What things are not covered by Medicare?

We don't cover these routine items and services: Routine or annual physical checkups (visit Medicare Wellness Visits to learn about exceptions). exams required by third parties, like insurance companies, businesses, or government agencies. Eye exams for prescribing, fitting, or changing eyeglasses.

What are non-covered services?

Non-covered services are services patients are responsible for paying on their own. Return to the full list of hospital price transparency questions.

How many PT sessions will Medicare pay for?

There's no limit on how much Medicare pays for your medically necessary outpatient physical therapy services in one calendar year.

Does Medicare cover dentures?

In most cases, Medicare doesn't cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures.

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38 related questions found

What does Medicare not cover for seniors?

Medicare doesn't cover supplies and services that aren't considered medically necessary, such as cosmetic surgery. The program also doesn't cover long-term care or most dental services.

What is an example of non-covered services?

Certain services are never considered for payment by Medicare. These include preventive examinations represented by CPT codes 99381-99397. Medicare only covers three immunizations (influenza, pneumonia, and hepatitis B) as prophylactic physician services.

What is non Medicare coverage?

Non-Medicare insurance is a form of private healthcare that offers more comprehensive coverage than Medicare. Although it is more expensive, non-medicare covers more of your healthcare needs. You can access Non-Medicare through your employer, privately, through the marketplace, and directly with insurance providers.

What is excluded under Medicare?

Long-term care includes non-medical care for people who have a chronic illness or disability. This includes non-skilled personal care assistance, like help with everyday activities, including dressing, bathing, and using the bathroom. Medicare and most health insurance plans, don't cover long-term care.

What blood tests does Medicare not cover for seniors?

It's important to know that Medicare won't cover any blood test if it isn't medically necessary. If you seek a blood test on your own, it's unlikely you'll get it covered. Tests not covered may include those for employment purposes, wellness screenings, or routine monitoring without medical necessity.

Will Medicare pay for a tummy tuck?

Tummy tucks, or abdominoplasty, are considered cosmetic procedures and are not covered by Medicaid or Medicare unless deemed medically necessary. Dual eligibility for Medicaid and Medicare is possible, with low-income seniors and disabled individuals often meeting the criteria for both programs.

Why are people leaving Medicare Advantage plans?

Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.

Does Medicare pay 100% of anything?

You'll usually pay 20% of the cost for each Medicare-covered service or item after you've paid your deductible. If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs, like deductibles, coinsurance, and copays. Learn more about help with costs.

Does Medicare cover dental implants?

While Medicare may pay for medical treatments related to implants, it won't pay for the implants themselves. For instance, if an oral surgery needs to be performed in a hospital to prepare for your implants, Medicare may cover costs related to the hospital, but not for the the surgery itself.

Which of the following is not covered by Medicare?

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine physical exams. Cosmetic surgery.

Does Medicare pay for haircuts?

Medicare may cover haircuts, shaves, shampoos, and simple hair sets if you're in a skilled nursing facility and cannot perform these tasks for yourself.

What is max out of pocket with Medicare?

Medicare Advantage (Part C): In 2025, the out-of-pocket maximum for Part C plans is $9,350 for approved services, but individual plans can set lower limits if they wish.

What are 5 treatments Medicare does not cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

What is the biggest disadvantage of Medicare Advantage?

The biggest disadvantage of Medicare Advantage is that you have fewer doctors to choose from when you get medical care.
  • Plans can also cost more overall than Original Medicare if you have complex medical needs. ...
  • With some plans, you don't have any coverage if you use a doctor that isn't in the network.

What part of Medicare is free when you turn 65?

People age 65 or older, who are citizens or permanent residents of the United States, are eligible for Medicare Part A. You're eligible for Part A at no cost at age 65 if 1 of the following applies: • You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB).

What if I have bad teeth and no money?

Affordable options like sliding scale clinics, dental schools, and payment plans can help with costs. If your teeth are rotting and you can't afford treatment, don't ignore it. Low-cost options like government programs or community health centers can help address the issue early.

What is the best dental plan for seniors on Medicare?

“My top picks for Medicare Advantage dental insurance include UnitedHealthcare, Cigna, Aetna, Humana and Devoted Health. These companies provide notable dental coverage, and there are different advantages for each. It's important to consider the insurance that the dentists in your area accept and the coverage provided.

How to get dentures for free?

How to Get Dentures For Free Or At A Discount
  1. Local Health Departments. ...
  2. Community Health Centers. ...
  3. Dental Schools. ...
  4. Clinical Trials. ...
  5. Dental Lifeline Network. ...
  6. Medicare. ...
  7. PACE (Program Of All-Inclusive Care For The Elderly) ...
  8. Medicaid Coverage.