Medicare pays for many — but not all — of the health care services you need. When you review your quarterly Part A or Part B Medicare Summary Notice, you may see claims made by a provider, facility or supplier that Medicare did not pay. Medicare generally does not cover:
Skilled Nursing or Rehabilitative Care: If you need skilled care immediately after leaving a hospital, Medicare will pay the full Medicare-allowed rate for the first 20 days you require skilled nursing or rehabilitation care. After that, you pay a part of the cost ($141.50 per day) for up to 100 days. Medicare doesn't provide skilled nursing or rehabilitation coverage for services that exceed 100 days in a row.
Personal Care Assistance: The cost of hiring help for bathing, toileting and dressing are not covered unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning, are covered only if you are receiving hospice care.
Alternative Medicine: Medicare does not cover acupuncture or chiropractic services (except to fix subluxation of the spine), or other types of alternative or complementary care.
Cosmetic Surgery: Medicare will not pay for elective cosmetic procedures, although certain surgeries may be covered if necessary to fix a malformation.
Vision, Hearing, Foot and Dental Care: Hearing aids, hearing exams and routine eye, foot and dental care are not covered, although some glasses after cataract surgery and hearing implants to treat a severe hearing loss may be covered.
Miscellaneous Hospital Costs: Inpatient charges for a private hospital room, or in-room television or telephone, will not be covered by Medicare.
Other Excluded Costs: Medicare does not pay for nonemergency transportation or copies of X-rays.
Overseas Coverage: In most cases, Medicare will not pay for health care you receive outside of the United States.
Of course, there are some exceptions to these exclusions, especially if you are enrolled in a Medicare Advantage plan. In addition, depending on the Medicare coverage you select, you will pay monthly premiums as well as annual deductibles, coinsurance and co-payments. You'll find a complete list of these costs in Medicare's Medicare & You booklet and at Medicare.gov. Information is also available by calling 800-MEDICARE (800-633-4227) or, if you use Medicare Advantage, by contacting your plan administrator.
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