Original Medicare (Parts A and B) helps millions of Americans pay for hospital stays, doctor visits, and many necessary medical services. But Medicare doesn’t cover everything. Knowing what’s not included will help you plan ahead and avoid unexpected costs.
Quick Refresher: What Parts A and B Does Cover
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Part A (Hospital Insurance): Helps pay for inpatient hospital stays, skilled nursing facility care, hospice, and some home health services.
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Part B (Medical Insurance): Helps pay for doctor visits, outpatient care, preventive services, and medical supplies.
Even with these benefits, there are gaps in coverage. If Medicare doesn’t cover a service, you’ll usually be responsible for the full cost unless you have a Medicare Supplement plan, Medicare Advantage plan, Medicaid, or some other form of insurance.
Common Services Not Covered by Original Medicare
Here are some of the most common things not included under Part A and Part B:
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Long-term care (custodial care): Ongoing care in a nursing home or at home when the main need is help with daily activities (like eating, bathing, dressing, and going to the bathroom).
- Most prescription drugs: You’ll need a separate Medicare Part D plan or an alternate insurance solution to receive assistance paying for retail medications.
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Most dental services and dentures: Routine dental exams, cleanings, fillings, extractions, root canals, and dentures are not covered under Original Medicare.
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Hearing exams, hearing aids, and hearing aid fittings: You’ll need other insurance to cover this cost, or expect to pay out-of-pocket.
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Routine vision care and eyeglasses/contact lenses: Except in certain medical cases, Medicare does not cover eye exams, glasses, or contacts. Receiving cataract surgery, for example, does sometimes mean that Medicare will cover these costs temporarily or partially.
- Routine foot care: Unless deemed medically necessary–for example, if you have been diagnosed with diabetes and you need extra help staving off things like diabetic neuropathy, sores, and infections–podiatrist and orthopedist visits are not covered.
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Alternative medical treatments: Treatments such as acupuncture and chiropractic adjustments are not covered for most conditions.
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Cosmetic surgery: Unless it’s medically necessary (for example, if reconstruction is needed after a traumatic accident or a cancerous mass removal), Medicare does not cover cosmetic procedures.
- Overseas care: Except in very rare circumstances, you’ll pay the complete cost of any healthcare you receive outside of the United States.
Other Out-of-Pocket Costs to Expect
Remember, even for services that Medicare does cover, you’ll still be responsible for certain costs:
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Deductibles: The amount you pay before Medicare begins to cover its share.
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Coinsurance: The percentage of costs you pay after meeting your deductible.
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Copayments: Fixed amounts for specific services, like doctor visits.
Why This Matters
Understanding Medicare’s limits helps you plan for the future. Many people choose to add a Medicare Supplement (Medigap) plan or enroll in a Medicare Advantage plan to help cover these gaps. Even if you decide not to enroll in a Medigap or Medicare Advantage plan, knowing when and where you’ll be supported financially by your insurance carrier will allow you to make informed decisions about your health and finances. If you’d like to learn more about your Medigap and Medicare Advtange plan options, check out our article ‘Understanding Medicare Advantage Plans.’
If you want the full, official list of what’s covered and not covered, check the government’s Medicare & You handbook or visit Medicare.gov. And of course, Empower Brokerage is here to walk you through your options and help you find the coverage that fits your needs.
Got Medicare Questions?
We hope that this information on what Medicare Part A and Part B does not cover has been useful to you.
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This article was updated 8/21/25.